Urogynecology Expert Forum
Dr. Hoyte - Rectocele Surgery + Sex
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Questions in the Urogynecology forum are answered by Bruce Crawford, MD, J. Kyle Mathews, MD, and other medical professionals and experts. Topics covered include overactive bladders, bladder pain, fallen/drooping bladder, bowel urgency, bowel prolapse, cystitis, incontinence, pain with intercourse, rectal prolapse, surgery, urinary urgency, and uterine prolapse.

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Dr. Hoyte - Rectocele Surgery + Sex

Oct. 12, 2007 member HATTEN posted a follow-up question regarding rectocele surgery and sex. It was never answered and my questions are the same.

To: Dr. Hoyte
You mention that the surgery could narrow the vaginal opening, is that always the case?  Also, is the vagina shortened to help with the repair?  Isn't there any other way to repair a bulging rectocele?  I have read something about site specific repair where the tissue is sutured very tightly to make the repair not disturbing any other areas.  Is this not an option?  I It is very obvious and I don't have to squat or strain.  I need repair but do not want to sacrifice my vagina and the possibility of future sexual relations with my husband.  What are the options, please?  Hatten

To add to this I am currently 5 months pregnant with our fourth and final child. I know I currently have no treatment options. My obgyn said a pessary would not help and kegels wouldn't either at this point. I have lower back pain, but that could be pregnancy related. The rectocele is uncomfortable, but not extremely. I am constantly on my feet. I am only 30 years of age and fear that having surgery would cause pain during intercourse (scar tissue, which I know is hard to "fix"). I have read articles from med. journals comparing site specific to standard posterior colporrhaphy (from 1994-1995?) Have not found anything newer comparing two methods of surgery. Although the article stated that site-specific has been "advocated as being superior to the standard posterior colporrhaphy for postoperative sexual and bowel function", the data did not support that statement.

Also, I have been unable to find out how much the surgery would cost out-of-pocket. Insurance may be an issue for me at that time. Typically, how long after labor/delivery would the surgery occur? THANKS IN ADVANCE FOR YOUR INFORMATIVE AND DETAILED ANSWERS.

Rectocele...who knew? You would think a mom of (soon to be) 4 would have known about this prior....
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Consider a laparoscopic procedure to re-suspend the uterus and vagina to the uterosacral ligaments. Alternatively you could consider an abdominal sacrohysteropexy, which can resuspend the vagina and uterus to the inside of the tailbone, using a graft placed via the abdomen. Neither procedure will shorten or narrow the vagina, but can be very effective at correcting the prolapse.
The site specific defect repair is less likely to narrow or shorten your vagina  but you should discuss this with your surgeon beforehand.

You want to wait about 3-6 months after delivery before having any vault suspension procedure done.

Dr. Hoyte


Dr. Hoyte

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