A rectocele is a bulge of the front wall of the rectum into the vagina. The rectal wall may become thinned and weak, and it may balloon out into the vagina during bowel movements. rectocele occur in women because of weakening of the pelvic support structures That may be due to multiple, difficult or prolonged deliveries, the use of forceps or other assisted methods of delivery, perineal tears, or an episiotomy into the rectum or anal sphincter muscles.
In addition constipation and straining with bowel movements, or hysterectomy may contribute to the development of a rectocele..Rectocele may bea part of a more generalized weakness of pelvic support and may exist along with a cystocele, urethrocele, and enterocele, or with uterine or vaginal prolapse, rectal prolapse, and fecal or urinary incontinence.Symptoms may be primarily vaginal or rectal.
How much does rectocele repair surgery cost in iran?
The rectocele repair surgery cost in iran start from 340$.
Vaginal symptoms include vaginal bulging, the sensation of a mass in the vagina, pain with intercourse or even something hanging out of the vagina that may become irritated. Vaginal bleeding is occasionally seen. Rectal symptoms include constipation with difficult evacuation with straining. Often this is associated with bulging in the vagina when straining to have a bowel movement. Some women find that pressing against the lower back wall of the vagina or along the rim of the vagina helps to empty the rectum. At times, there will be a rapid return of the urge to have a bowel movement after leaving the bathroom because stool that was trapped in the rectocele may return to the low rectum after standing up. A general feelingof pelvic pressure or discomfort is often present but this may be due to a variety of problems.Most rectoceles may be identified on a routine examination of the vagina and rectum. . rectocle that are not causing symptoms do not need to be treated. Avoid constipation and prolonged straining by eating a high fiber diet and drinking plenty of fluids.If symptoms persist even with medical therapy, then surgical repair may be indicated.
If non-surgical methods do not help control rectocele symptoms, surgery may be needed. Talking with a reconstructive surgeon who specializes in pelvic floor conditions can help women decide upon the best approach. In most cases, surgery is done under general anesthesia and takes approximately 1 hour.
There are a number of different surgical repair options, each of which takes its name from the path used by the surgeon to reach the rectocele.
Transvaginal repair: The rectocele is reached through the vagina. This is the traditional approach to rectocele repair by gynecologists. It offers the chance to correct not only the rectocele but a relaxed perineum and widened vaginal opening. It also has the advantage of not disturbing any tissue in the rectal area.
Transperineal repair: The rectocele is reached through the perineum. This method allows the surgical removal of hemorrhoids at the same time, if necessary. However, it usually requires the implanting of a mesh over the entire surgical area to provide added support following surgery.
Transanal repair: The rectocele is reached through the anus. This method is preferred by many colorectal surgeons because it allows for correction of problems in the anal or rectal area, in addition to repairing the rectocele. Some studies also suggest that pain after surgery may be less with this method than with the transvaginal approach.
Other types of repairs include:
Laparoscopic repair uses a laparoscope, a thin lighted tube that needs only a small opening to reach the area being repaired. Advantages to this method include clearer visibility of the affected area, quicker recovery time, less pain, and a shorter hospital stay. Disadvantages include difficulties with suturing, increased procedure time and expense, and extra time on the part of the surgeon to master laparoscopic techniques.
Ventral-rectopexy involves the use of a polypropylene (flexible plastic) mesh that is stitched to the front of the rectum and attached to the back of the pelvis (the hip bone) using special types of tacks. The mesh pulls up the bowel and prevents it from sagging down into the vaginal wall. This operation may be performed using a laparoscope.
Other types of mesh are made from the tissue surrounding a cow’s heart, or from pig skin and intestine. These materials closely resemble the type of tissue found along the wall of the vagina.
General anesthesia is usually used for repair of a rectocele . You may stay in the hospital from 1 to 2 days. Most women can return to their normal activities in about 6 weeks. Avoid strenuous activity for the first 6 weeks. And increase your activity level gradually.
Normal bowel function returns within 2 to 4 weeks. It is important to avoid constipation during this time. Your doctor will give you special bowel care instructions. But it is important to include sources of fibre and adequate fluids in your diet. Try to drink about 6 to 8 glasses of water a day.
Most women are able to resume sexual intercourse in about 6 weeks.
Surgical repair of rectoceles is used to manage symptoms such as movement of the intestine that pushes against the wall of the vagina, low back pain, and painful intercourse. An Rectocele may not cause symptoms until it is so large that it bulges into the midpoint of the vaginal canal.
Rectocele often occur with other pelvic organ prolapse, so tell your doctor about other symptoms you may be having. If your doctor finds a bladder prolapse (cystocele), urethral prolapse (urethrocele), or uterine prolapse during your pelvic examination, that problem can also be repaired during surgery.
Not much is known about how well the surgery works over time. The surgery is more likely to be successful if the woman can avoid constipation, does not go through pregnancy and delivery, and does not have any other pelvic organ prolapse.
Risks of rectocele repair surgery are uncommon but include:
Bowel or rectal injury.
Formation of an abnormal connection or opening between two organs (fistula).
What To Think About
Pelvic organ prolapse is strongly linked to labour and vaginal delivery. So you may want to delay surgical repair of a rectocele until you have finished having children.
Surgical repair may relieve some, but not all, of the problems caused by a rectocele .
If pelvic pain, low back pain, or pain with intercourse is present before surgery, the pain may still occur after surgery.
Symptoms of constipation may return following surgery.
The success rate is lower if you have had previous pelvic surgery or radiation therapy to the pelvis.
You can control many of the activities that contributed to your rectocele or made it worse. After surgery:
Stay at a healthy weight for your height.
Avoid activities that put strain on the lower pelvic muscles, such as heavy lifting or long periods of standing.
Complete the surgery information form (PDF) ( What is a PDF document? ) to help you prepare for this surgery.