Urogynecology Community
Rectocele
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WELCOME TO THE UROGYNECOLOGY COMMUNITY for WOMEN: This Patient-To-Patient Community is for discussions relating to Female Incontinence and Pelvic Floor disorders such as, Cystocele, Drooping Bladder, Intercourse Pain, Pelvic Organ Prolapse, Vaginal Relaxation and Vulvodynia.

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Rectocele

In the procedure you have the rectum, connective tissue and then the vagina.  Is this right?  so the connective tissue is in between?
When they do surgery is it possible to stitch the rectum to the connective tissue?  

How would i know if the doctor stitched the rectum to the connective tissue ? What would the symptoms be?

Let me know what you think. I am having a lot of pressure at the rectum area.  It moves around.  Could he have attached the rectum to the connective tissue?  Therefore there is nothing separating the rectum from the vagina??  Could there be something in the rectum that is blocking the opening?  Could this be muscle tightness???
Please help???
Here is my response to your questions
1. What were the symptoms that you had earlier to the surgery?
trouble sitting.  Feeling like i was sitting on stool--in area of vagina and rectum
Stool getting stuck in there and feeling like i was sitting on stool. Pressure at back of vagina from the rectum area.

2. What was the diagnosis made by the doctor earlier to performing the surgery?

rectocele Grade 2 acting like a grade 4    Uterus and bladder well supported.  He actually saw it because it was acting up at an office visit.
I will tell you that i fully did not understand the procedure and the risks.  Never once did someone tell me that i would not be able to sit down.
3. What is the procedure that you are talking about?
recetocele repair with stiches  no mesh used

4. I am under the impression that the surgery has already been done and that you are not planning it going ahead?
June 2011

It would also be better if you can send across the operation notes and any reports if you have.
Latest report  9 weeks postop--Bladder and rectum well supported.  No levator spasm.  Rectal exam revealed wnl rectovaginal support, no mass, no foreign body, no perineocle

It would also be better if you can send across the operation notes and any reports if you have.
PROCEDURE: Patient was brought to the Operating Room where she was placed
in supine position. General anesthesia was administered via endotracheal
tube and found to be adequate. She was then repositioned in dorsal
lithotomy position using hydraulic Allen stirrups. TED stockings and
sequential compression devices were placed on both lower extremities for
DVT prophylaxis. She received 1 gram of Ancef for infectious prophylaxis.
She was then examined, prepped and draped in the usual sterile fashion. A
formal timeout was then performed with all surgical team members present
and in agreement with the surgical plan.
Attention was then paid to her urethra. Foley catheter was inserted under
sterile technique to drain her bladder. A Lone Star retractor was
assembled. Allis clamps were then placed at 5 o'clock and 7 o'clock of the
hymenal ring as well as in the midline of the posterior vaginal wall with
tenting of the posterior vaginal wall. The rectovaginal space was then
infiltrated with dilute vasopressin solution. A transverse incision was
made with 10 blade scalpel across the hymenal ring and was carried to the
midline sharply using Metzenbaum scissors. The rectocele defect was
isolated both sharply and bluntly. in the rectovaginal septum
was confirmed on the rectovaginal exam. Dissection was made to perform
posterior colporrhaphy to imbricate the rectovaginal muscularis in the
midline in 1 layer using 2-0 PDS suture in an interrupted fashion. Apical
portion of the rectovaginal septum was reapproximated to the endocervix of
the vaginal epithelium. The vaginal epithelium was then trimmed with
Metzenbaum scissor. The vaginal epithelium was then reapproximated using
2-0 Vicryl suture in interrupted fashion. The transverse aspect of the
incision was then reapproximated using 3-0 Vicryl suture in a running
fashion. This completed, the posterior colporrhaphy. Of note, rectovaginal
examination was performed prior to epithelial reapproximation to confirm
the repair of rectovaginal rectocele defect and no foreign material was
noted in the rectum. Vaginal packing with Premarin cream was then placed
into the vagina after hemostasis was assured. The Foley catheter was left.
All the instruments, needle and sponges were counted and were correct x2.
The patient was awoken from her anesthesia and was extubated and was
transported to the PACU in a stable condition.

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1128665_tn?1269277071
Please post this to the  dr side of forum, I can not analyze the surgical report for you. You can copy/paste it to a urogynecologist forum; I'm hopeful they'll be able to provide additional insight to what I have already shared.
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