Rectocele Surgery – A rectocele is a condition that occurs when the rectum protrudes into the vagina. Also known as a bowel hernia, a rectocele typically occurs as a result of weakness or damage to the pelvic floor muscles.

Intestinal Hernia (Rectocele) Symptoms

The symptoms of a rectocele (herniated bowel) can vary from person to person, and some people may experience no noticeable symptoms, while others may experience more severe symptoms. Symptoms of a rectocele may include:

• A sensation of tissue or a mass in the vagina or anus: A rectocele occurs when the rectum protrudes forward into the vaginal canal. This can create a sensation of tissue or a mass in the vagina or anus. A person may feel as if something is inside or touching the prolapsed tissue.
• Vaginal or rectal pressure: A rectocele can press down on the rectum due to a weak pelvic floor. This can create a feeling of pressure or heaviness in the vaginal or rectal area. This sensation is often worse after prolonged standing, sitting, or heavy lifting.
• Straining during bowel movements or a feeling of incomplete evacuation: Because a rectocele pushes the rectum downward, a person may feel a sense of straining during bowel movements. A person may feel unable to have a bowel movement completely or that they are not fully evacuated. This can lead to constipation or irregular bowel movements.
• Pain or discomfort during sex: Because a rectocele creates a prolapse inside the vaginal canal, pain or discomfort may be felt during intercourse. This may occur when rectocele symptoms are more pronounced.

Rectocele symptoms often vary depending on the severity of the symptoms. In mild cases of rectocele, symptoms may be minimal or absent. However, in more advanced cases of rectocele, symptoms can be more noticeable and bothersome. If you experience symptoms of a rectocele, it's important to see a healthcare professional for an evaluation.

What Causes Intestinal Hernia (Rectocele)?

A rectocele usually occurs as a result of weakness or damage to the pelvic floor muscles. The pelvic floor is a structure composed of muscles, ligaments, and tissues that support the pelvic organs. Causes of a rectocele may include:

• Childbirth: Vaginal delivery can cause the pelvic floor muscles and ligaments to stretch and weaken. Women who have had a particularly long or difficult labor may be at higher risk of a rectocele. This can weaken the pelvic floor muscles and cause the rectum to prolapse into the vaginal canal.
• Aging: Pelvic floor muscles and ligaments naturally weaken with age, increasing the risk of a rectocele.
• Chronic constipation: Long-term constipation can cause large amounts of stool to be retained in the intestines. This can strain the intestines and increase pressure on the pelvic floor. Over time, this can cause the rectum to prolapse into the vaginal canal.
• Overstraining: Overstraining can be associated with factors such as repeatedly lifting heavy objects, engaging in excessively strenuous exercise, or consistently straining to have bowel movements due to constipation. These can increase the risk of a rectocele by increasing pressure on the pelvic floor.
• Genetic predisposition: Some people may have a genetic weakness in their pelvic floor structure or connective tissue. This can predispose them to types of pelvic organ prolapse, such as rectocele.

A combination of factors usually contribute to the development of a rectocele. In all cases, weakness or damage to the pelvic floor is the primary mechanism that causes the rectum to prolapse into the vaginal canal.

How is a Rectocele Diagnosed?

A bowel hernia is a condition that typically requires an examination and evaluation by a doctor to diagnose. Below are some common methods used to diagnose a bowel hernia:

• Physical exam: The doctor will assess the patient's symptoms and health history and perform a pelvic exam. During this exam, the doctor will feel around the pelvic organs, using the vagina and/or rectum to detect a rectocele or other signs of pelvic organ prolapse.
• Digital rectal exam: Wearing a glove, the doctor inserts a finger into the rectum and assesses the rectal wall to feel for the presence of a rectocele. During this exam, the doctor can determine the size, position, and other characteristics of the rectocele.
• Pelvic ultrasound: Ultrasound uses sound waves to create images of the pelvic organs. Pelvic ultrasound can be used to evaluate the size and location of a rectocele and associated pelvic structures.
• Bowel function tests: Bowel function tests may be performed to identify symptoms such as constipation or bowel movement difficulties. These tests can help diagnose a rectocele by evaluating factors such as bowel motility, bowel movement time, stool consistency, and more.
• Bowel imaging: In some cases, radiographic imaging may be used to diagnose a bowel herniation. These may include a bowel x-ray (X-ray imaging of the intestines) or bowel defecography (radiographic imaging of bowel movements).

The diagnostic process may vary depending on the severity of symptoms, the patient's health history, and clinical findings.

How is a Rectocele Treated?

Treatment for a rectocele (intestinal hernia) can vary depending on the severity of symptoms, the patient's lifestyle, and preferences. Treatment options are described below:

Conservative treatment: In some cases of rectocele with mild symptoms, conservative treatment may be recommended to relieve symptoms. These treatment methods may include:

• A diet high in fiber: Adequate fiber intake can help prevent constipation and regulate bowel movements.
• Fluid intake: Drinking enough water can help keep stools soft and bowel movements easier.
• Preventing constipation: For regular bowel movements, it is important to engage in physical activity, consume fiber-rich foods, and use anti-constipation medications when necessary.

Pelvic floor exercises: Exercises to strengthen the pelvic floor muscles may help relieve rectocele symptoms. Pelvic floor exercises may be recommended by a physical therapist or pelvic floor health specialist.

Pessary use: A pessary is a device inserted into the vagina and can help support the pelvic organs. A specially designed pessary may be used to relieve symptoms of a rectocele. Pessary selection and placement should be performed by a healthcare professional.

Surgical Treatment: Surgery may be considered in cases of rectocele that are severe or have failed conservative treatment. Surgical treatment involves surgery to correct the rectocele and support the pelvic organs. The surgical treatment option varies depending on the severity of symptoms, the patient's overall health, and their preferences.

The most appropriate treatment option for a rectocele should be determined after an evaluation by a healthcare professional. The treatment approach should be personalized, taking into account the severity of symptoms, the patient's lifestyle, and preferences.

Does Rectocele Cause Hemorrhoids ?

A relationship between rectoceles (herniated bowel) and hemorrhoids may exist, but this is not always the case. A rectocele is a prolapse of the rectum into the vaginal canal, while hemorrhoids are enlarged and swollen veins around the anus. A rectocele is associated with weakness or damage to the pelvic floor, while hemorrhoids are usually caused by factors such as constipation, prolonged sitting, or persistent straining. The two conditions may share common risk factors and, in some cases, can coexist.

A rectocele can cause bowel movements to become irregular and constipation to occur due to weakening of the pelvic floor and displacement of the rectum. Constipation, in turn, can make defecation difficult and lead to excessive straining. This excessive straining can increase pressure on the veins around the anus and contribute to the development of hemorrhoids.

Therefore, there may be an indirect relationship between rectoceles and hemorrhoids. A rectocele can increase the risk of developing hemorrhoids by exacerbating constipation. However, it's important to note that not every rectocele will develop into a hemorrhoid, nor will every hemorrhoid be associated with a rectocele. Both conditions can have different causes, and their treatments may also differ.

What are the Costs of Intestinal Hernia Surgery (Rectocele)?

Rectocele surgery (Intestinal Hernia) costs can vary depending on many factors. You can visit Ankara Private Magnet Hospital for a preliminary consultation with our General Surgery doctor and receive pricing information. To easily reach us and schedule an appointment, call   0312 212 80 80.

How is Intestinal Hernia Surgery (Rectocele) Performed?

When surgery is necessary to treat a rectocele (a herniated bowel), a rectocele repair (rectocele surgery) may be performed. Rectocele surgery is performed to correct the prolapse of the rectum into the vaginal canal and provide support for the pelvic organs. A general description of rectocele surgery:

Anesthesia: The surgery is usually performed under general anesthesia, which allows the patient to sleep and not feel any pain. In some cases, local anesthesia or epidural anesthesia may also be preferred.

Surgical approach: Rectocele surgery can usually be performed vaginally or abdominally. The preferred method depends on the size of the rectocele, the patient's condition, and the surgeon's preferences.

• Vaginal approach: Vaginal rectocele surgery involves making an incision through the vagina. The rectocele is repaired and stitches are placed in the vaginal walls to support the pelvic organs.
• Abdominal approach: Rectocele surgery, performed through the abdomen, is usually performed as laparoscopic or open surgery. Laparoscopic surgery involves making small incisions in the abdomen using a camera and surgical instruments. Open surgery is performed through a larger incision. This approach involves stitches to correct the rectocele and support the pelvic organs.

Pelvic organ support: Various methods can be used to support the pelvic organs during rectocele surgery. This may include suturing the vaginal walls or using pelvic organ slings or synthetic mesh.

Stitches and closure: After the rectocele is corrected and the pelvic organs are supported, the surgeon stitches the incisions and closes the operation site.

Rectocele surgery typically takes a few hours, and postoperative recovery typically takes several weeks. During the recovery period, it's important to follow your surgeon's instructions, including rest and avoiding certain activities.

What Should Be Considered After Intestinal Hernia Surgery (Rectocele) Treatment?

After rectocele (bowel hernia) treatment, it's important to follow certain precautions to support the healing process and reduce the risk of complications. Things to keep in mind after rectocele treatment:

• Follow your doctor's instructions: Follow your doctor's instructions exactly throughout your treatment. Take your medications regularly, keep follow-up appointments, and inform your surgeon of any concerns or problems.
• Rest and activity level: It's important to rest for a period of time after surgery. Avoid strenuous physical activity for the duration recommended by your surgeon. You can gradually increase your activity level during recovery, but it's important to avoid overly strenuous activities.
• Hygiene : It's important to follow post-operative hygiene guidelines. Keep the perineal area clean and wipe carefully after using the toilet. You can use damp toilet paper or a gentle cleansing cloth. Keep the perineal area dry to avoid contact with urine and stool.
• High-fiber diet: Adopt a high-fiber diet to prevent constipation and regulate bowel movements. Consuming adequate amounts of fruits, vegetables, whole grains, and fiber-rich foods will support digestive health. However, be sure to follow the dietary instructions recommended by your surgeon.
• Fluid intake: Drinking enough fluids helps soften stools and reduces the risk of constipation. Increase your daily water intake and avoid alcoholic beverages and caffeine.
• Pain and discomfort management: Pain and discomfort are normal after surgery. Take pain relievers prescribed by your doctor regularly and rest when you experience discomfort. Warm compresses or sitz baths can help relieve pain.
• Sexual Intercourse: The timing of returning to sexual intercourse is determined by your surgeon's recommendation. Sexual activity can usually be resumed after a few weeks or more. Follow your surgeon's instructions and consult your doctor if you experience any discomfort or concerns.

Precautions after rectocele treatment may vary depending on the patient's condition, the surgical method, and the surgeon's recommendations. It's important to follow your doctor's instructions and report any concerns you may have during your post-operative recovery.