Rectocele

David E Beck; Nechol L Allen

doi:10.1055/s-0030-1254295

Clinics in Colon and Rectal Surgery, Table of Contents

Clin Colon Rectal Surg 2010; 23(2): 090-098
DOI: 10.1055/s-0030-1254295

Rectocele

David E. Beck¹ , Nechol L. Allen¹

¹Department of Colon and Rectal Surgery, Ochsner Clinic Foundation, New Orleans, Louisiana

Abstract

ABSTRACT

Rectoceles are common and involve a herniation of the rectum into the posterior vaginal wall that results in a vaginal bulge. Women with rectoceles generally complain of perineal and vaginal pressure, obstructive defecation, constipation, or the need to splint or digitally reduce the vagina to effectuate a bowel movement. Rectoceles are associated with age and parturition and arise from either a tear or stretching of the rectovaginal fascia, and can be repaired via a vaginal, anal, or perineal approach. Although the rate of successful anatomic repair is high, reports of functional outcome are more variable.

KEYWORDS

Rectocele - posterior colporrhaphy - defecation disorders

Full Text

References

REFERENCES

1 Rosato G O. Rectocele and perineal hernias. In Beck DE, Wexner SD Fundamentals of Anorectal Surgery. London; WB Saunders 1998: 187-197
2 Pollak J, Davila G W. Rectocele repair: the gynecologic approach. Clin Colon Rectal Surg. 2003; 16 61-69
3 Richardson A C. The rectovaginal septum revisited: its relationship to rectocele and its importance in rectocele repair. Clin Obstet Gynecol. 1993; 36(4) 976-983
4 Uhlenhuth E, Wolfe W M, Smith E M, Middleton E B. The rectogenital septum. Surg Gynecol Obstet. 1948; 86(2) 148-163
5 Milley P S, Nichols D H. A correlative investigation of the human rectovaginal septum. Anat Rec. 1969; 163(3) 443-451
6 DeLancey J OL. Anatomic aspects of vaginal eversion after hysterectomy. Am J Obstet Gynecol. 1992; 166(6 Pt 1) 1717-1724 discussion 1724-1728
7 Shull B L, Bachofen C G. Enterocele and rectocele. In: Walters MD, Karram MM Urogynecology and reconstructive pelvic surgery. 2^nd ed. St. Louis; Mosby 1999: 221-234
8 Kahn M A, Stanton S L. Techniques of rectocele repair and their effects of bowel function. Int Urogynecol J. 1998; 9 37-47
9 Delancey J OL, Hurd W W. Size of the urogenital hiatus in the levator ani muscles in normal women and women with pelvic organ prolapse. Obstet Gynecol. 1998; 91(3) 364-368
10 Bartram C I, Mahieu P HG. Evacuation proctography and anal endosonography. In: Henry MM, Swash M Coloproctology and the Pelvic Floor. 2nd ed. London; Butterworth-Heinemann 1992: 149-561
11 Jorge J MN, Wexner S D, Marchetti F, Rosato G O, Sullivan M L, Jagelman D G. How reliable are currently available methods of measuring the anorectal angle?. Dis Colon Rectum. 1992; 35(4) 332-338
12 Yoshioka K, Matsui Y, Yamada O et al.. Physiologic and anatomic assessment of patients with rectocele. Dis Colon Rectum. 1991; 34(8) 704-708
13 Lu R H. [Rectocele: analysis of 239 cases]. Ching Hua Wai Ko Tsa Chih. 1990; 28(2) 102-104 127
14 Lucas J D, Landy L B. The gynecologist's approach to anterior rectoceles. Semin Colon Rectal Surg. 1992; 3(2) 138-143
15 Ambroze W L, Pemberton J H, Bell A M, Brown M L, Zinsmeister A R. The effect of stool consistency on rectal and neorectal emptying. Dis Colon Rectum. 1991; 34(1) 1-7
16 Halligan S, Bartram C I. Is barium trapping in rectoceles significant?. Dis Colon Rectum. 1995; 38(7) 764-768
17 Ting K-H, Mangel E, Eibl-Eibesfeldt B, Müller-Lissner S A. Is the volume retained after defecation a valuable parameter at defecography?. Dis Colon Rectum. 1992; 35(8) 762-767
18 Johansson C, Nilsson B Y, Holmström B, Dolk A, Mellgren A. Association between rectocele and paradoxical sphincter response. Dis Colon Rectum. 1992; 35(5) 503-509
19 Block I R. Transrectal repair of rectocele using obliterative suture. Dis Colon Rectum. 1986; 29 707-711
20 Khubchandani I T, Sheets J A, Stasik J J, Hakki A R. Endorectal repair of rectocele. Dis Colon Rectum. 1983; 26(12) 792-796
21 Sehapayak S. Transrectal repair of rectocele: an extended armamentarium of colorectal surgeons. A report of 355 cases. Dis Colon Rectum. 1985; 28(6) 422-433
22 Nichols D H. Posterior colporrhaphy and perineorrhaphy: separate and distinct operations. Am J Obstet Gynecol. 1991; 164(3) 714-721
23 Francis W J, Jeffcoate T N. Dyspareunia following vaginal operations. J Obstet Gynaecol Br Commonw. 1961; 68 1-10
24 Kahn M A, Stanton S L. Posterior colporrhaphy: its effects on bowel and sexual function. Br J Obstet Gynaecol. 1997; 104(1) 82-86
25 Cundiff G W, Weidner A C, Visco A G, Addison W A, Bump R C. An anatomic and functional assessment of the discrete defect rectocele repair. Am J Obstet Gynecol. 1998; 179(6 Pt 1) 1451-1456 discussion 1456-1457
26 Porter W E, Steele A, Walsh P, Kohli N, Karram M M. The anatomic and functional outcomes of defect-specific rectocele repairs. Am J Obstet Gynecol. 1999; 181(6) 1353-1358 discussion 1358-1359
27 Paraiso M F, Barber M D, Muir T W, Walters M D. Rectocele repair: a randomized trial of three surgical techniques including graft augmentation. Am J Obstet Gynecol. 2006; 195(6) 1762-1771
28 Sand P K, Koduri S, Lobel R W et al.. Prospective randomized trial of polyglactin 910 mesh to prevent recurrence of cystoceles and rectoceles. Am J Obstet Gynecol. 2001; 184(7) 1357-1362 discussion 1362-1364
29 Marks M M. The rectal side of the rectocele. Dis Colon Rectum. 1967; 10(5) 387-388
30 Arnold M W, Stewart W RC, Aguilar P S. Rectocele repair. Four years' experience. Dis Colon Rectum. 1990; 33(8) 684-687
31 Khubchandani I T, Clancy III J P, Rosen L, Riether R D, Stasik Jr J J. Endorectal repair of rectocele revisited. Br J Surg. 1997; 84(1) 89-91
32 Murthy V K, Orkin B A, Smith L E, Glassman L M. Excellent outcome using selective criteria for rectocele repair. Dis Colon Rectum. 1996; 39 374-378
33 Sehapayak S. Transrectal repair of rectocele: an extended armamentarium of colorectal surgeons. Dis Colon Rectum. 1985; 6 422-433
34 Arnold M W, Stewart W RC, Aguilar P S. Rectocele repair. Four years' experience. Dis Colon Rectum. 1990; 33(8) 684-687
35 Fox S D, Stanton S L. Vault prolapse and rectocele: assessment of repair using sacrocolpopexy with mesh interposition. Br J Obstet Gynaecol. 2000; 107 1371-1375
36 Taylor G M, Ballard P, Jarvis G J. Vault prolapse and rectocele: assessment of repair using sacrocolpopexy with mesh interposition. Br J Obstet Gynaecol. 2001; 8 775-776
37 Paraiso M FR, Falcone T, Walters M D. Laparoscopic surgery for enterocele, vaginal apex prolapse and rectocele. Int Urogynecol J. 1997; 8 146-152
38 Lyons T L, Winer W K. Laparoscopic rectocele repair using polyglactin mesh. J Am Assoc Gynecol Laparosc. 1997; 4(3) 381-384

David E BeckM.D.

Department of Colon and Rectal Surgery, Ochsner Clinic Foundation

1514 Jefferson Hwy., New Orleans, LA 70121

Email: dbeckmd@aol.com