What you need to know about Rectocele Repair

Do you sometimes feel like something is going down your vagina, like a ball? Or do you have a hard time going to the toilet, like your bowels are not emptying completely? The reason for this discomfort may be a condition called 'Rectocele', where your rectum protrudes into the vagina. Many women are embarrassed to talk about this, but it is an important topic that we need to talk about. So, let's talk about it in detail.

What is Rectocele? Why is it surgically removed?

Simply put, our rectum is the last part of the large intestine. It is located behind the vagina. When the tissue that separates these two organs weakens, the rectum starts to protrude into the vagina. It's like when a wall weakens, something on the other side pushes in. This is what we call a Rectocele .

If the prolapse is causing symptoms such as discomfort, pain, difficulty defecating, or pain during sex that interfere with daily life, and if nonsurgical treatments are not able to control it, doctors usually recommend surgery. This surgery is also called a posterior colporrhaphy . This surgery works by strengthening the weakened tissue and stopping the prolapse.

How do you prepare for surgery?

Your doctor will give you a clear set of instructions about this. Following those instructions exactly can greatly reduce the risk of unwanted complications. You may usually be asked to do these things before surgery.

What happens during surgery?

Don't be afraid of the surgery. It will happen without you knowing anything. These are the steps that are usually followed:

• Anesthesia: You will be put under general anesthesia, so you will not feel any pain.
• Antibiotics: Antibiotics are given through a vein (IV) to prevent infections.
• Incision: A small incision is made in the back wall of the vagina. This may be done through the vagina (transvaginal), through the anus (transanal), or through the area between the two (perineum).
• Urinary catheterization: A temporary tube (catheter) is inserted to drain urine.
• Repair: The weakened tissue between the vagina and anus is repaired using sutures or other reinforcement methods (mesh is now rarely recommended for this purpose).
• Correction of other problems: If there are other problems, for example, prolapse of other organs, these can also be corrected during this surgery.
• Closing the incision: Finally, the incision is sewn back shut.

This surgery usually takes about an hour, but depending on your condition, and if other issues are being addressed at the same time, it may take a little longer.

Benefits and potential risks of surgery

As with any surgery, there are benefits as well as some minor risks. It is important to be aware of these beforehand.

Recovery time and things to consider

It usually takes three to six weeks to fully recover. This varies from person to person. You may feel a little tired for the first few days. Gradually, you will be able to return to your normal activities.

Remember these things during recovery:

• Avoid sexual intercourse: Avoid sexual intercourse until your doctor gives you permission, usually for at least 6 weeks.
• Avoid constipation: It is very important to avoid constipation during this time. Eat a high-fiber diet (more than 25 grams per day), fruits, vegetables, and drink plenty of water. If necessary, your doctor will prescribe stool softeners.
• Avoid heavy lifting: Avoid heavy lifting, strenuous exercise, and running for a few weeks. However, you can do things like walking and climbing stairs right after the surgery. They will not harm the surgery.
• Vaginal discharge: During the healing process, you may experience a small amount of vaginal discharge or a few drops of blood. This is normal. However, if the bleeding is heavy or has a foul odor , call your doctor immediately.

Correct posture for defecating after surgery

Having a bowel movement after surgery can be a bit of a challenge, but using the right posture can greatly reduce pain and strain.

• Avoid straining: Never strain. Keeping the stool soft helps with this.
• Sit properly on the toilet: Don't raise your feet off the floor. Keep your feet flat on the floor. Use a small stool if necessary.
• Bend forward: Keep your chest pressed towards your knees and your hips in a natural curve.
• Raise your knees: Placing a footstool under your feet and keeping your knees slightly higher than your hips can make it easier to defecate.

Can't you avoid surgery?

Of course, yes. Not all cases of Rectocele require surgery. If the symptoms are not too severe, there are ways to manage the condition without surgery.

• Diet: Prevent constipation by eating a high-fiber diet and drinking plenty of water daily.
• Pelvic floor exercises: Exercises like Kegel exercises can help strengthen the pelvic floor muscles around the vagina and anus. Ask your doctor about this.
• Pessary: ​​A small device (pessary) inserted into the vagina can reduce prolapse.

Only if these methods fail to control symptoms should surgery be considered.

When to seek immediate medical advice

If any of the following symptoms appear during your recovery, call your doctor immediately.

• Excessive bleeding
• A vaginal discharge with a bad odor
• Severe pain
• Fever

Rectocele, Rectocele Repair, Posterior colporrhaphy, Rectal prolapse, Vaginal surgery, Women's health, pelvic floor, constipation