Rectocele..Please Help

[viclee]

I am in need of a urogynegologist. I am unable to void on my own and I have lived with this condition for the past 10 years.  I have had pencil thin movements for 6 years. I get scoped every two years and my colon has no disorders. I have splinted the past 5 years to start movements. But this year my bowels have locked down twice and the gastroenterologist precribed colon prep laxtives to resolve the problem. The splinting no longer works....I take Milk of Magnesia every three days to liquidy the movements so I can pass a movement. I have been living like this the past 6 months. I believe the rectal canal is almost blocked now.
My gastroenterlogist recommended I see my ob as I might have a rectocele. No rectal examination has been reformed so I do not actually know what is wrong.  I would like recommendations on board certified physicans with a fellowship expericened in the field of prolapse. I live in Stanton,Texas and can travel to any location. I refer to go to a place that specializes in prolapses. I keep putting this condition off due to the fact I want an experienced specialist and have no idea whom to contact. Any recommendations would be greatly appreciated. Which procedures are the most successful, the least invasive and which should I avoid ? I am sexually active and would prefer not to ruin my sex life. Thanks so much

[J. Kyle Mathews, MD, DVM]

HI,

Sorry to hear of your issues.  Recotceles are common and often cause problems such as you describe.  The diagnosis is usually straight forward based on pelvic examination.  Repair of rectocele has traditionally been done by gynecologist or colorectal surgeons by bring together the muscles of the pelvis over the rectum.  This procedure, while effective, is anatomically incorrect and can cause pelvic pain.  Newer techniques often use mesh to repair the rectocele.  The mesh may be an absorbable type or a permanent type of mesh.  Most often this is done through a vaginal approach.  Often other areas of the vagina need to be addressed as well.  These can be done at the same time and usually a single overnight stay is all that is required.  Most patients may return to work in 10 to 14 days.

I recommend to my patients repair of rectocele using either absorbable or permanent mesh.  Both have a 10% failure rate in my hands.  All mesh carries a risk of exposure at a later date meaning the mesh may be exposed through the vaginal mucosa at sometime in the future.  Obviously this tends to be more of a problem with permanent mesh than with absorbable mesh.  However, permanent mesh tends to last longer.  Mesh exposures are usually small and can be handled in the office however, if the mesh becomes infected, it must be removed in the operating room.  

It should be noted that the use of mesh in the vagina is a topic that is often debated in the Urogynecology community.  There are many on each side of the debate that are passionate about their point of view.  Patients should be given the best information available to help them make an informed decision.  

Urogynecologist and gynecologist can repair a rectocele successfully for you.  I would be surprised if there wasn’t a gynecologist in your area that would be able to help you.  Unfortunately, I am unaware of any urogynecologist in your area.  My practice is located in Plano, Texas, a suburb of Dallas.  I would be happy to assist you if you cannot find a suitable solution in you area.  JKM

[belkins]

I too have a rectocele. IT has been a tough road starting with a hysterectomy in Aug 2009. Two months later my bladder fell and went back to surgery to get it tacked up. Now I have a vaginal vault starting to collapse with a large rectocele. I had a gynecologist do the surgerys and I wish I had gone to a specialist and had it done right at first. I do not know your age but you need to get it taken care of. There is several things they can do now that is not to long for the recovery.