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"What is rectocele?"


After giving birth to our second child, my wife has a shape bulging in her vagina that our doctor called a retocele; he suggested that she get surgery to repair it. What is this thing? Does she definitely need a surgical repair if it doesn't bother her? She's pretty tired of the hospital.


A rectocele is a specific form of the group of disorders known as pelvic organ prolapse. Normally, the rectum and vagina are supported and separated by a sturdy, fibrous partition known as the rectovaginal septum. Over time, this septum may be weakened; this weakness is commonly exacerbated by chronically increased abdominal pressure and/or through vaginal deliveries.

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When the septum is weakened, portions of the posterior wall of the vagina (closest to the rectum) may bulge inward, toward the vaginal canal; this is referred to as a rectocele. The formation of the rectocele may be otherwise asymptomatic, or can be associated with feelings of pelvic pressure, constipation, and difficulty or pain with intercourse, for example. Treatment of the rectocele varies from patient to patient, and includes factors such as age, comorbid medical conditions, the severity of the prolapse, and the degree of symptoms caused by the rectocele. Asymptomatic patients may be monitored and prescribed muscle strengthening techniques. Women with mild symptoms may choose to undergo a trial of a vaginal pessary, which is inserted into the vagina to support the structure of the surrounding walls. For more severe cases, surgery is the best option; pelvic organ prolapse such as rectocele accounts for more than 200,000 surgeries done in the U.S. every year. Your wife should have a conversation with her OB/GYN physician to discuss her various options for treatment.

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