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Rectocele Repair
Surgery in Hyderabad

What is Rectocele Repair ?

Rectocele repair, also known as posterior vaginal wall repair, is a surgical procedure used to treat a Rectocele, where the rectum bulges into the back wall of the vagina due to weakened pelvic floor muscles. This condition commonly occurs after childbirth, ageing, or prolonged strain and can lead to symptoms such as vaginal bulging, pelvic pressure, and difficulty with bowel movements. The surgery is recommended when these symptoms become bothersome and do not improve with non-surgical treatments like pelvic floor exercises or lifestyle changes.
The procedure involves making an incision in the vaginal wall and repairing the weakened tissue between the rectum and vagina by tightening and reinforcing it. In some cases, excess tissue is removed to restore normal anatomy and improve support. The goal of rectocele repair is to relieve discomfort, improve bowel function, and enhance overall quality of life by restoring proper pelvic floor structure.

Types of Rectocele Repair (Posterior Vaginal Wall Repair):

Rectocele repair is not a single standardised procedure; it includes several surgical techniques tailored to the patient’s anatomy, severity of prolapse, symptoms, and overall health. The goal across all methods is to restore the strength of the vaginal wall, properly support the rectum, and improve bowel function while minimising recurrence.
Posterior Colporrhaphy (Conventional Repair): This is the most widely performed technique for treating a Rectocele. In this procedure, the surgeon makes an incision in the posterior vaginal wall and tightens the stretched or weakened connective tissue (fascia) between the rectum and vagina. Excess vaginal tissue may also be removed to reduce bulging. It is particularly effective for generalised weakness of the pelvic floor and offers reliable long-term results with relatively low complication rates.
Site-Specific Repair: Unlike traditional repair, this approach focuses on identifying and correcting individual defects in the supporting tissue rather than tightening the entire area. The surgeon locates specific tears or separations in the fascia and repairs them precisely.
This technique helps preserve normal anatomy and may reduce the risk of over-tightening, making it suitable for patients with localised defects and those who require a more anatomically targeted repair.
Transanal Rectocele Repair: In this method, the repair is performed through the anal canal rather than the vagina. It is often chosen when bowel-related symptoms such as obstructed defecation or incomplete evacuation are the primary concern. The procedure involves reinforcing the rectal wall and correcting the bulge from the rectal side. While it can improve bowel function, it may not address vaginal symptoms as effectively as vaginal approaches, so patient selection is important.
Mesh-Augmented Repair:  In more complex or recurrent cases, additional support may be provided using synthetic or biological mesh. The mesh acts as a scaffold to strengthen weakened tissues and reduce the risk of recurrence. However, due to potential complications such as infection, erosion, or discomfort, this method is used cautiously and only when clearly indicated. Careful evaluation and counselling are essential before choosing this option.
Combined or Multicompartment Repair: Some patients have rectocele along with other forms of pelvic organ prolapse (such as uterine or bladder prolapse). In such cases, surgeons may perform a combined procedure to correct multiple defects in a single surgery. This comprehensive approach ensures balanced pelvic support and helps prevent recurrence in untreated compartments.