Posterior Repair (Rectocele)

Posterior Repair (Rectocele) Surgery (also called posterior wall repair) can strengthen and repair the damaged tissue and restore the rectum to its normal position.

A Posterior Repair (Rectocele) is a bulging of the rectum into the vagina. It happens when the tissues that support the rectum and vagina are weakened and torn.

Vaginal childbirth, chronic constipation, and heavy lifting all increase your risk of rectocele, as they can damage the tissue that supports the rectum and vagina.

Before your Procedure

Here’s what you can expect before Posterior Repair (Rectocele) repair surgery:

• You’ll have blood and urine tests.
• The day before your surgery, you’ll be asked to fast (not eat anything), and you may be given a special liquid to help empty your bowels.
• Hair on your pubic area and abdomen may be clipped to help keep the incision sites sterile.
• To prevent infection, you’ll be given antibiotics.
• A nurse will place an IV — a small tube put through a needle into a vein — in your arm or wrist to deliver fluids, medication, or blood as needed.
• You’ll be attached to monitors and given anesthesia. Depending on your preference and on how your surgery will be done, you may have general anesthesia (which puts you completely asleep during the surgery) or a regional anesthesia (which blocks the feeling in the lower part of your body).
• A catheter — a thin tube — will be placed in your bladder. The catheter 

Posterior Repair (Rectocele) Procedure

Rectocele repair surgeries are usually done through the vagina or the perineum (the skin between the vagina and the anus). The approach your doctor recommends will depend in part on the severity of the rectocele. Once the area of the rectocele is reached, surgery includes these general steps:

• The surgeon makes one or more incisions (cuts) along the back wall of the vagina (the side closest to the rectum).
• Stitches are sewn into the weakened tissue around the vagina and rectum, and along the vaginal wall. (The stitches can strengthen your tissues in two ways: first, by closing any tears, and second, by encouraging scar tissue to build in the area for extra support).
• •If necessary, the perineum will be repaired with deep stitches into the muscle.
• •The vaginal incisions are closed with stitches and the vagina may be packed with gauze.
• Note that the stitches used in this surgery will eventually be absorbed by the body. They don’t need to be removed.

Recovery

After a Posterior Repair (Rectocele) surgery, you may need to stay in the hospital for 23 hours. Here’s what to expect:

• To help prevent blood clots, your nurses will encourage you to walk as soon as possible after surgery. Also, a pneumatic compression device will massage your legs by inflating and deflating.
• You’ll have some pain. Your doctor will prescribe medication to help control the pain.
• You’ll have vaginal bleeding and discharge. Sanitary pads will help absorb this.
• You’ll learn how to care for yourself at home during your recovery period. Your nurse will go over the instructions in the next section of this fact sheet and will answer any questions you have.

Risks

All surgeries carry risks, while rare, complications may include:

• Blood clots in the veins or lungs
• Infection
• Bleeding during or after surgery
• Rectocele repair failure, or rectocele recurrence
• Injury to the rectum or nearby organs
• Problems related to anesthesia
• Sexual dysfunction caused by poor healing of the vaginal incisions or from damage to nerves