Rectocele Repair

When the bulge into the vagina comes from the rectum it is called a rectocele. As with other forms of pelvic organ prolapse (cystoceles, enteroceles, vaginal prolapse) childbirth, chronic cough, chronic constipation, and obesity are predisposing factors. Symptoms are similar to cystoceles such as pelvic pressure, an unsightly bulge in the vagina, and constipation. It is sometimes hard to tell if the bulge is from the bladder or rectum and the examining physician will need to use a “Half Speculum” to define what is hanging out. Furthermore, the need of reaching into the vagina to push stool out is not uncommon and a giveaway that the rectum is falling out and giving symptoms. Of course, both the rectum and bladder can fall out together at the same time. Surgical repair consists of using sutures to bunch up the bulging tissues together or bringing muscles together into a new flat floorboard. More modern repair consists of the use of mesh or donor tissues. Rectocele repairs have a 90-95% success rate when the muscles are approximated together.

Internal Mommy Makeover

A very big rectocele (large bowel) with an enterocele (small bowel) coming out together and being repaired along with the placement of an incontinence sling, vaginoplasty, and perineoplasty for an internal Mommy Makeover.

rectocele-mommy makeover

moderate rectocele

Moderate Rectocele

severe rectocele

Severe Rectocele – It hangs out another 2cm when patient bears down
A complete dissection of a rectocele bulge

complete dissection rectocele

Case Study: Bulging Rectocele and Gaping Vaginal Opening

Here is a patient who had bulging rectocele, an open and gaping vaginal opening, which have the appearance of floppy labia minora. I repaired the rectocele and did a Barbie Look Labiaplasty with Clitoral Hood Reduction.

Rectocele case 1

Case Study: Rectocele and Perineocele

Here is an example of a bulging perineum that turned out to be both a rectocele and a perineocele (a bulge of large bowel, the rectum, pushing up agains the perineum).  It caused a huge gaping appearance and a lack of friction during sex.  The patient complained the labia looked old and saggy and that the multiple loose folds of skin on her perineum were ugly and that she wanted it smooth.  I performed a rectocele repair, perineocele repair, vaginoplasty, perineoplasty, Hybrid Look Labiaplasty, and clitoral hood reduction, Vampire Wing Lift, and O-Shot.  I have maintained the appearance for over a decade now using ThermiVa radiofrequency to keep the tissues tight and smooth.