Benefits and Risks of Rectocele Repair with Mesh Surgery

What is Rectocele?

Rectoceles form when the fibrous tissue that separates the vagina and the rectum becomes weak, and the wall of the rectum bulges into the vagina. Things that can lead to a rectocele include birthing and major stress on the vaginal walls. Rectoceles normally occur after the onset of menopause or any time the estrogen level in the body is decreased, as estrogen keeps these tissues strong and helps them stay in place.

The pessary is a plastic or rubber ring that is inserted vaginally to help support the bulging tissues. There are many types available on the market, but many women choose not to use them due to the fact they are hard to use and manipulate. Some require a doctor to remove and clean, and then reinsert. Surgery with mesh is commonly used when the rectocele protrudes out of the vaginal canal.

Rectocele Repair with Mesh Surgery

When the rectocele protrudes, this can be a painful sign that it is time for surgery. Your doctor may suggest surgery if a rectocele is found along with other conditions like cystocele or uterine prolapse. Surgical repair is generally required for these types of conjunctive conditions. During the surgery, you will be anesthetized and the surgeon will create incisions in the vaginal walls and rectum. Mesh is used to reinforce the sagging or protruding tissues so that they are no longer loose.The mesh is held in place with stitches, which help to strengthen the wall that separates the vagina and the rectum. If the incision is created in the rectum, the procedure is called a transperineal mesh repair. If the incision is created in the vaginal wall, the procedure is called a transvaginal rectocele repair. You will remain in the hospital for at least one night after the surgery.

Studies

Several studies tested the efficacy of the collagen mesh that is used for rectocele repair in women. In one study, 32 women underwent the collagen mesh repair surgery and 29 of those women underwent an assessment after surgery. At six months after surgery, 26 women had stage two rectocele and three patients had stage three rectocele. At the 12-month mark, 15 women had a rectocele and the other 14 had none. It was found that collagen mesh provided great support for proper functioning of the tissues and muscles. Unfortunately, there was a large risk for recurrence after one year. The National Center for Biotechnology Information indicates that more evaluation is needed before this procedure is used as a regular treatment for rectocele.

Resource

MayoClinic.com - Rectocele