Rectocele
| Classification according to ICD-10 | |
|---|---|
| N81.6 | Rectocele |
| ICD-10 online (WHO version 2019) | |
A rectocele (syn. Rectocele ) is a protrusion of the anterior rectal wall into the vagina due to a weakness of the wall layers between the rectum and the vagina (lat. Rectovaginale septum ). A rectocele is often associated with a subsidence of the pelvic floor , a pre-existing tendency to constipation and several births. The development of the symptoms in their entirety is often self-reinforcing in the sense of a vicious circle ( "Circulus vitiosus" ).
Symptoms
The leading symptomatology is initially a feeling of pressure in the pelvic area, later a feeling of incomplete emptying after a bowel movement and, as the disease progresses, with increasing size and bulging or bulging, a passage obstacle with resulting constipation . At this stage, patients typically help themselves with manual counterpressure from the vagina in order to be able to successfully empty themselves.
treatment
A small, asymptomatic rectocele does not require any further therapy. If the symptoms are relevant, a conservative (non-surgical) approach is initially recommended. See the spectrum of possibilities described in the chapter on constipation or constipation . In addition to the therapies described, there is the possibility of stabilizing the rectovaginal septum with a painless, outpatient syringe treatment (sclerotherapy) . Several sessions are usually required to achieve the full effect.
If these measures do not lead to sufficient success over a longer period of time, with consistent application and exhaustion of the entire conservative therapy spectrum, surgical therapy options may have to be considered. The question of whether an operation makes sense should be discussed carefully with the help of a qualified specialist and should not be taken lightly. Even an operation does not guarantee complete success and, depending on the extent of the intervention, harbors corresponding operative risks.
literature
- L. Berman, J. Aversa, F. Abir, WE Longo: Management of disorders of the posterior pelvic floor. In: Yale J Biol Med. 2005 Jul; 78 (4), pp. 211-221. Review. PMID 16720016
