Urogynecology Expert Forum
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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Rectocele surgery & sex

I have been agonizing over whether to have this repair surgery. I have seen a highly recommended urogynocologist twice to discuss it but I still am not clear on how the end result will affect my vagina and sex. I've heard that the size of the vaginal opening may be a bit smaller? Is this true? and that length of the vagina is shortened, making sex painful - does the length stretch out eventually?

Thank you
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If you have prolapse (bulging beyond the labia), AND symptoms like constipation, having to splint with your fingers to have a bowel movement, or difficulty with sexual entry, then you may benefit from a repair of the rectocele. If you do not have any of the above, then you probably do not need to have it repaired. The rectocele repair can sometimes narrow the vaginal opening, depending on how your urogynecologist chooses to do the procedure. If you or your partner cannot see the bulge when you squat and strain down, then you probably don't need a repair. Ask your urogynecologist to tell you the stage of the prolapse. If it is stage 2 or less, then it may not be the source of your symptoms, and you might not receive any benefit drom surgery. Usually stage 3 or 4 (it only goes up to  stage 4), will be associated with symptoms, which can sometimes improve with proper repair surgery. If you have no symptoms (dull back ache/pain with prolonged standing, irritation from the bulging vagina, urinary frequency, difficulty with sexual entry), then I am not sure what the surgery is going to help.

Dr. Hoyte.
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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 have a bulging rectocele but have none of the symptoms you mention above.  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
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A related discussion, anal sex was started.
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A related discussion, rectocele was started.
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A related discussion, A & P repair. Sex & too much tissue in vagina. was started.
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