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Rektosel ve Cerrahi Tedavisi

Posterior vaginal wall prolapse; When the thin wall of tissue that separates the rectum from the vagina weakens, it allows the vaginal wall to swell. Some physicians refer to posterior vaginal prolapse rectocele. Childbirth and other processes that put pressure on the pelvic tissues can cause posterior vaginal prolapse. A small prolapse shows no signs or symptoms.

If the rectocele is large, it can produce significant tissue swelling from the vaginal opening. This swelling can be uncomfortable but is rarely painful. If needed, self-care measures and other non-surgical options are often effective. Rectocele may require surgical repair if the patient has many complaints.

What are the symptoms of rectocele?

A small posterior vaginal prolapse (rectocele) may cause no signs or symptoms.

Otherwise, you may notice:

  • A soft tissue protrusion in your vagina that can protrude through the vaginal opening
  • Difficulty in bowel movement
  • Rectal pressure or feeling of fullness
  • Feeling that the rectum is not completely emptied after a bowel movement
  • Due to the looseness of the vaginal tissue; dissatisfaction with sexual life, feeling of shame

When to see a doctor?

Posterior vaginal prolapse is common even in women who have no children. In fact, you may not even know you have posterior vaginal prolapse. However, sometimes moderate or severe posterior vaginal prolapses can be uncomfortable or uncomfortable. Consult your doctor if:

  • You have an uncomfortable lump of tissue protruding from your vaginal opening
  • If the symptoms do not improve even though you have been treated for constipation

What are the causes of rectocele?

Posterior vaginal prolapse is caused by pressure on the pelvic floor. Causes of increased pelvic floor pressure include:

  • Chronic constipation or straining with bowel movements
  • Chronic cough or bronchitis
  • Repetitive heavy lifting
  • Being overweight or obese

Pregnancy and childbirth

The muscles, ligaments, and connective tissue that support your vagina stretch and weaken during pregnancy, labor, and delivery. The more pregnancies you have, the greater your chance of developing a posterior vaginal prolapse. Women who deliver by cesarean section only are less likely to develop a posterior vaginal prolapse, but it can still happen.

Risk factors

Factors that may increase your risk of posterior vaginal prolapse include:

  • Genetics: Some women are born with weaker connective tissues in the pelvic area, which naturally increases the likelihood of developing posterior vaginal prolapse.
  • Birth: If you have given birth to more than one child vaginally, the risk of developing a posterior vaginal prolapse is higher.
  • Aging: As you age, you naturally lose muscle mass, elasticity and nerve function, causing the muscles to tense or weaken.
  • Obesity: Extra body weight puts pressure on pelvic floor tissues.

How do we prevent it?

Try the following to reduce your risk of worsening posterior vaginal prolapse:

  • Do Kegel exercises regularly. These exercises can strengthen your pelvic floor muscles – especially important after you have a baby.
  • Treat and prevent constipation. Drink plenty of fluids and eat high-fiber foods such as fruits, vegetables, beans and whole grain cereals.
  • Avoid heavy lifting and lift properly. When lifting, use your legs rather than your lower back or back.
  • Control the cough. Treat chronic cough or bronchitis and do not smoke.
  • Avoid weight gain. Talk to your doctor to determine your ideal weight and, if necessary, seek advice on weight loss strategies.

Diagnosis of Large Intestine Herniation

The diagnosis of a rectocele is usually made during a pelvic exam of your vagina and rectum. During a pelvic exam, your doctor will likely ask you:

  • He may ask you to push,
  • She may ask you to pretend you are holding back to keep from urinating or passing gas.

You can fill out a questionnaire that helps you evaluate how far the swelling extends into your vagina and how much it affects your quality of life. This information helps guide treatment decisions.

Rarely, your doctor may recommend imaging tests:

  • MRI or an X-ray can determine the extent of tissue swelling
  • Defachography can determine how efficiently your rectum empties.

Treatment

Treatment depends on the severity of the posterior vaginal prolapse. Your doctor may suggest:

  • Observation: If your posterior vaginal prolapse causes few or no symptoms, simple self-care measures like doing Kegel exercises to strengthen your pelvic muscles can provide relief.
  • Pesser: A vaginal pessary is a plastic or silicone ring placed in the vagina to support swollen tissues. A pessary should be removed regularly for cleaning.
  • Surgery: Surgical repair may be required in the following situations:
    • If the droop is protruding from the vagina and is particularly uncomfortable
    • If sagging bothers you and you have uterine sagging in addition to this condition. Surgical repair can be completed at the same time for any situation.

The surgery uses a vaginal approach and usually involves removing the excess, stretched tissue that creates the posterior vaginal prolapse. Currently, we do not use mesh treatment (patch) for rectocele surgery.

Lifestyle changes

Depending on the severity of your posterior vaginal prolapse, self-care measures may provide relief. Try these:

  • Do Kegel exercises to strengthen the pelvic muscles and support the weakened fascia (For detailed information on Kegel exercises, you can find the topic on my website)
  • Avoid constipation by eating high-fiber foods and drinking plenty of fluids
  • Avoid bed to get your bowels moving
  • Avoid heavy lifting
  • Control the cough
  • Lose weight if you are overweight or obese

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