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Clin Colon Rectal Surg 2008; 21(2): 129-137
DOI: 10.1055/s-2008-1075862
© Thieme Medical Publishers

Functional Disorders: Rectocele

Roger Lefevre1 , G. Willy Davila1
  • 1Department of Gynecology, Section of Urogynecology and Reconstructive Pelvic Surgery, Cleveland Clinic Florida, Weston, Florida
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Publication History

Publication Date:
29 April 2008 (online)

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ABSTRACT

The baseline prevalence of rectocele is not well defined as many women are asymptomatic and do not seek medical help. Gynecologists tend to perform posterior wall repairs more commonly than colorectal surgeons because they also address patients with vaginal symptoms in addition to those with defecatory dysfunction. Overall, surgical correction success rates for rectocele correction are quite high when using a vaginal approach. Vaginal dissection, as opposed to transrectal or transperineal approaches, results in better visualization and access to the endopelvic fascia and levator musculature, allowing for more firm anatomic correction. In addition, the maintenance of rectal mucosal integrity may reduce the risk of postoperative complications such as infection and fistula formation. With the rapidly growing popularity of synthetic and biologic implant kits in the field of pelvic reconstruction, outcomes data reporting is increasing and allowing surgeons to better understand the effect of various surgical techniques on vaginal, sexual, and defecatory symptoms.

KEYWORDS

Rectocele - posterior colporrhaphy - site-specific defect rectocele repair - dyspareunia - defecation disorders

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G. Willy DavilaM.D. 

Department of Gynecology, Cleveland Clinic Florida

2950 Cleveland Clinic Blvd., Weston, FL 33331

Email: davilag@ccf.org