Rectocele

Term «rectocele “Literally translates as” a bag of the rectum. This term refers to the protrusion of the anterior wall of the rectum towards the vagina. This disease occurs in women, as a rule, as a result of severe, traumatic childbirth. Contributing factors are hard physical labor, obesity, weakness of the apparatus that supports the pelvic organs. Rectocele is a common pathology that occurs in almost every second woman who visits a proctologist.

The main complaint with all this disease is constipation. Defecation is difficult, there is a feeling of incomplete emptying of the rectum, the feeling of compression disappears when straining. As the disease develops, it becomes necessary to use manual assistance during stool, prolonged straining, frequent, ineffective urge to defecate. A rectocele can be the main, and sometimes the only, cause of persistent constipation. With all this, many notice that the intestines “work” if you support or press your fingers on the back wall of the vagina or on the sides of the anus.

The basis of the disease is the divergence of the anterior portion of the muscles that lift the anus, as well as the weakening of the muscular frame of the perineum and recto-vaginal septum. In fact, a variant of a vaginal hernia occurs when a weakened wall between the intestine and the vagina, instead of “working” to evacuate the contents of the intestine when straining, protrudes into the vagina, “suppressing” defecation. The failure of the pelvic floor muscles leads not only to the above complaints, but also to urinary incontinence during tension (when coughing, sneezing), to problems in the sexual sphere. That is why many specialists (gynecologists, proctologists) point out that rectocele and prolapse of the female genital organs are a common process with a single etiology and clinical picture.

In the initial stages of the disease, conservativetreatments: special diet, physiotherapy exercises, including anal gymnastics, physiotherapy, etc. In some cases, this gives an effect, but more often the disease progresses. Surgery is the real cure. During the surgical intervention, the separated portions of the pelvic muscles (the so-called levators) are sutured, which makes it possible to restore the usual anatomical relationships of the muscular-fascial structures of the pelvic floor. The approach to the treatment of diseases of the perineum should be comprehensive. In the presence of concomitant pathology (cystocele, hemorrhoids, anal fissure, polyps, etc.), their simultaneous surgical correction is performed. Usually already during the first stool for 2-3 days after the operation, patients notice a change in the quality of the stool, its lightness and effectiveness. Patients tolerate this operation relatively easily, from the second day they begin to walk, they are carried out in the hospital,

Of course, like any operation, these interventions require serious medical training. Performed according to indications and in sufficient volume, they give good results. It should be pointed out that it will be necessary to observe a sparing regimen for 2-3 months after the operation.

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