Rectocele is the softness , rupture, disintegration or melting of the existing barrier.of the tissue between the rectum, which is the last part of the intestine, and the vagina, which is the beginning of female organ .
Therefore, it is during defecation a disease characterized by swelling from the rectum which is, the last part of the intestine towards the vagina , with difficulty in defecation .
The most important complaints of rectocele patients that they feel something like to give birth during defecation by pressing around the anus hole , because they can not remove the stool during defecation .
In advanced rectocele disease, it is tried to remove the stool by supporting the vagina with the help of fingers.
For this reason, it is a disease that can cause patients to stay away from social and business life.
Pain associated with increased pressure in the pelvis is another clinical finding.
When you feel relax with the help of hot application it is one of the disease features.
The biggest factor of the disease is difficult and prolonged births.
It seems to be quite common in our country, as the frequency of normal births is high and especially the patients in rural areas straining for a long time due to difficult births cause the barrier between them to disperse and rupture.
The disease is classified according to the width of the herniated area. Accordingly, hernias smaller than 2 cm are called small degree rectocele, those between 2 and 4 cm are called moderate rectocele and hernias larger than 4 cm are called large degree rectocele.
Although a detailed proctological examination is often sufficient in the diagnosis, defecography examination has an important place in determining the diagnosis and stage of the disease in patients who are in between. Today, MR DEFECOGRAPHY can give very clear results in patients thanks to the combination of defecography, which is a normal radiological examination, and an MRI device.
In the treatment of the disease, gynecologists and general surgeons try to help our patients. In advanced cases, it is necessary to plan and implement together gynecologists and general surgeons with teamwork.
In early stage rectocele disease, increasing the consumption of pulp, taking sufficient amount of fluid, regulating toilet habits and developing the levator muscles which are the abdominal floor muscles by kegel exercises , can mostly regress the complaints of the patients.
Contrary to popular belief, there is no possibility of it turning into a malignant bowel disease in the continouse follow-up of rectocele disease.
Therefore, in the planning of the treatment of the disease, the patient's complaints should be taken into consideration first and foremost.
If patients with rectocele complaints in MRI defecography have concomitant clinical complaints, surgery should be planned.
Generally, the approach is different between gynecologists and general surgeons in the planning of surgery.
While obstetricians mostly prefer vaginal repair, general surgeons mostly use anal repair or transperineal mesh repair, which results in the opening of the wall between the anal and the vagina and placing a patch there.
Whichever approach is taken, the important thing is to plan the treatment by paying attention to the injury of the anal region muscles, the wall of the large intestine and the abdominal floor muscles.
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