Treatment of Cystocele and Rectocele

A rectocele is a protrusion of the anterior rectal wall through the posterior vaginal wall. The disease refers to pelvic organ prolapse. You can get rid of the condition once and for all with surgery. Hospitals abroad offer modern, non-traumatic operations that provide reliable results while maintaining the ability to have a sexual life. You are welcome to use the Booking Health service to find out the prices and make an appointment for your treatment abroad.

Content

1. Diagnostics
2. Conservative treatment
3. What operations can be performed for rectoceles?
4. Why is it best to undergo your treatment of rectocele abroad?

Diagnostics

Most women with rectoceles visit a doctor with complaints of pelvic discomfort, constipation, and difficulty defecation. Pain during sexual intercourse and vaginal erosions are also possible.

The diagnostics of the disease predominantly involve clinical methods, such as vaginal and rectal examinations, as well as abdominal wall palpation. During a vaginal examination, doctors assess the severity of rectoceles according to the Baden-Walker or POP-Q systems.

Additional diagnostics can be used to detect other aspects of pelvic organ prolapse and concomitant diseases, as well as when preparing for surgery. Doctors conduct a mirror examination of the cervix, make an ultrasound scan of the pelvic organs, and perform defecography, which is an X-ray scan with the administration of a contrast agent into the vagina, bladder, and rectum.

Other examinations are not often required. But still, doctors sometimes use urodynamic tests (for urinary disorders) or dynamic MRI (it is performed in cases where the symptoms are severe and do not correspond to the severity of the prolapse according to the clinical examination results).

Conservative treatment

Rectoceles can be treated with conservative methods. Such a treatment allows for the regression of symptoms, slowing down the development of the disease, and even lowering the severity of the pathology.

Kegel exercises are recommended to strengthen the pelvic floor muscles. An additional tool is physiotherapy, which improves blood circulation and increases the effect of training. It also reduces the severity of the symptoms of the disease. It is important to lower intra-abdominal pressure, thereby getting rid of constipation. To do this, it is often enough to increase the intake of fiber (vegetables and fruits) and water.

If these measures are not enough, the next step is the use of gynecologic pessaries. They are placed in the vagina and prevent the protrusion of the rectum through its wall. Pessaries come in different shapes and sizes and are selected for each patient individually. It is important that the pessary is comfortable, does not cause any complications, and does not shift when tilting or defecating.

This method is not suitable for all patients. Risk factors for an unsuccessful pessary fitting include a large genital slit, a short vagina, and previous operations to repair pelvic organ prolapse.

What operations can be performed for rectoceles?

Surgical treatment of a rectocele is indicated if symptoms cannot be controlled with conservative methods. Surgery is often performed to eliminate obstructed bowel movements.

Operations can be performed through the following three surgical approaches:

• through the vagina;
• through the stomach;
• through the rectum.

There are also combined surgical approaches. For example, doctors may perform an intervention through the vagina and make abdominal incisions to place the mesh in the rectovaginal space.

When choosing a treatment method, doctors take into account the patient's age, the length of her vagina, her desire to have sex, the severity of her prolapse, and the severity of her bowel symptoms. In addition, preference often depends on the surgeon's skills. Proctologists often perform surgery through the anus, while gynecologists operate through the vagina and abdominal incisions.

Posterior colporrhaphy through a vaginal approach is considered the main method of rectocele surgery, which is used in most women. Doctors cut and suture the posterior vaginal wall to strengthen it. Folds are made in weak places, and sutures are applied. Perineoplasty (perineal plastic surgery) can also be done. This is a very effective operation that, even in countries with poor medicine, is successful in 76% of cases, and at the best hospitals abroad, the efficiency of this surgical option reaches 97%.

Endoanal (endorectal) plastic repair is less common and less efficient. In addition, the disadvantage of the method is frequent pain during sexual intercourse, so this treatment option is suitable for women who are not sexually active. Doctors at hospitals abroad perform rectovaginal fascia plication without plicating the levator to avoid creating a ring around the vagina that prevents sexual intercourse.

Plastic surgery with implants is rarely used. Doctors may place a mesh to strengthen the posterior vaginal wall. Such an approach is used only for highly severe rectoceles. This technique is not suitable for women who are sexually active. Mesh placement increases the risk of complications, and in most patients, the technique is not more effective than posterior colporrhaphy.

Why is it best to undergo your treatment of rectocele abroad?

If you have been diagnosed with a rectocele and want to get rid of this disease forever, it is best to seek medical attention from one of the hospitals abroad. The Booking Health website will help you select the most suitable center. On our website, you can see the best hospitals in the world, find out the cost of treatment, and compare prices.

There are a few reasons for you to undergo your treatment of rectocele abroad. These are the following:

• highly accurate diagnostics: many women with rectoceles also have displacement of other pelvic organs;
• most patients with rectoceles undergo a non-traumatic operation through a vaginal approach;
• the efficiency of surgery at the best hospitals reaches 97%;
• a low risk of recurrence;
• successful treatment of even highly severe prolapse;
• simultaneous treatment of rectocele and uterine prolapse, or prolapse of the bladder, urethra, and small intestine whenever required;
• the possibility of sexual intercourse without pain remains.

You are welcome to make an appointment for your diagnostics and surgical treatment abroad through the Booking Health website. The prices for medical services for you will be lower than when contacting a hospital directly, due to the lack of additional taxes for foreign patients.

Authors: 

The article was edited by medical experts, board-certified doctors Dr. Nadezhda Ivanisova and Dr. Vadim Zhiliuk. For the treatment of the conditions referred to in the article, you must consult a doctor; the information in the article is not intended for self-medication!

Sources:

Web MD

Verywell Health

Google Scholar