Rectocele Repair Surgery - Intermountain Healthcare

FACT SHEET FOR PATIENTS AND FAMILIES

Rectocele Repair Surgery

What is it? rectum in
normal position
A rectocele is a bulging of the rectum into the vagina.
(See the pictures at right.) It happens when the tissues that uterus
support the rectum and vagina are weakened and torn.
Rectocele repair surgery (also called posterior wall bladder rectum bulging into
repair) can strengthen and repair the damaged tissue vagina (rectocele)
and restore the rectum to its normal position.
vagina
Vaginal childbirth, chronic constipation, and heavy lifting
all increase your risk of rectocele, as they can damage the Rectocele repair surgery
tissue that supports the rectum and vagina. can restore the rectum to

Why do I need it? its normal position.

Your doctor may recommend surgery to treat a large or •• Stitches are sewn into the weakened tissue around the
severe rectocele, especially if it brings symptoms such vagina and rectum, and along the vaginal wall. (The
as these: stitches can strengthen your tissues in two ways: first, by
closing any tears, and second, by encouraging scar tissue
•• Bulging, pain, and discomfort in the vagina to build in the area for extra support).

•• Difficult bowel movements •• If necessary, the perineum will be repaired with deep
stitches into the muscle.
•• A feeling of pressure or “fullness” in your bowels,
even when you’ve just had a bowel movement •• The vaginal incisions are closed with stitches and the
vagina may be packed with gauze.
•• Inability to control your bowel movements
Note that the stitches used in this surgery will eventually
Because rectocele repair is a major surgery, a doctor will be absorbed by the body. They don’t need to be removed.
often suggest it after other treatments have failed to correct
the problem. Sometimes rectocele repair is done at the same Talking with your doctor about
time as a hysterectomy (surgery to remove the uterus). rectocele repair surgery?

How is it done? To decide whether to have a rectocele repair surgery, talk to
your doctor. Discuss the surgery’s potential benefits, its
Rectocele repair surgeries are usually done through the risks, and your treatment alternatives. The table on the next
vagina or the perineum (the skin between the vagina and page lists the most common of these, but other benefits and
the anus). The approach your doctor recommends will risks may apply in your unique medical situation. As you
depend in part on the severity of the rectocele. Once the talk to your doctor feel free to ask questions.
area of the rectocele is reached, surgery includes these
general steps: 1

•• The surgeon makes one or more incisions (cuts)
along the back wall of the vagina (the side closest to
the rectum).

What happens BEFORE the surgery? •• You’ll have vaginal bleeding and discharge. Sanitary
pads will help absorb this.
Here’s what you can expect before rectocele repair surgery:
•• You’ll learn how to care for yourself at home during
•• You’ll have blood and urine tests. your recovery period. Your nurse will go over the
instructions in the next section of this fact sheet and
•• The day before your surgery, you’ll be asked to fast (not will answer any questions you have.
eat anything), and you may be given a special liquid to
help empty your bowels. How do I care for myself at home?

•• Hair on your pubic area and abdomen may be clipped Recovery is different for every woman, and has a lot to
to help keep the incision sites sterile. do with the type of surgery you’ve had. It can last
anywhere from 3 to 8 weeks. This section gives
•• To prevent infection, you’ll be given antibiotics. information to help you know what to expect — and
what to do — as you recover at home. (Be sure to follow
•• A nurse will place an IV — a small tube put through the specific instructions of your own care team if they’re
a needle into a vein — in your arm or wrist to deliver different from what you see here.)
fluids, medication, or blood as needed.
Vaginal discharge
•• You’ll be attached to monitors and given anesthesia.
Depending on your preference and on how your surgery After a rectocele repair, it’s normal to have light vaginal
will be done, you may have general anesthesia (which discharge for up to 6 weeks. At first, the discharge tends
puts you completely asleep during the surgery) or a to be bright red or pink. Gradually, it changes to a
regional anesthesia (which blocks the feeling in the brownish or yellowish color. Here’s what to do to take
lower part of your body). care of yourself:

•• A catheter — a thin tube — will be placed in your •• Use pads to absorb discharge. Change them every
bladder. The catheter drains urine from your bladder time you go to the bathroom.
during the surgery.
•• Do NOT douche, use tampons, or have sex.
What happens AFTER the surgery? Ask your doctor when it’s okay to do so.

After a rectocele repair surgery, you may need to stay in •• Wipe front to back after going to the bathroom.
the hospital for a few days. Here’s what to expect: This helps prevent infection.

•• To help prevent blood clots, your nurses will encourage •• CALL YOUR DOCTOR if the discharge becomes
you to walk as soon as possible after surgery. Also, a foul-smelling, or if the discharge becomes heavier
pneumatic compression device will massage your legs by than a light menstrual period.
inflating and deflating.
•• GET EMERGENCY CARE if your bleeding is heavier than
•• You’ll have some pain. Your doctor will prescribe a normal menstrual period, or if you pass bright red clots.
medication to help control the pain.

Potential benefits Risks and potential complications Alternatives

of rectocele repair surgery of rectocele repair surgery •• Pessary (a device
placed in the vagina to
The aim of surgery is to repair and •• Rectocele repair failure, or rectocele recurrence hold the rectum
strengthen the wall between the vagina •• Blood clots in the veins or lungs in place)
and rectum to: •• Infection
•• Relieve pain and discomfort caused by •• Bleeding during or after surgery 2
•• Injury to the rectum or nearby organs
the rectocele •• Problems related to anesthesia
•• Improve bowel control •• Sexual dysfunction caused by poor healing of the vaginal
•• Allow for more physical activity and
incisions or from damage to nerves
more comfortable sexual activity

Pain Bathing

Your pain and soreness should gradually go away as the You may take a shower after the first 48 hours, but do
days pass. Cramps, a bloated abdomen, and low back pain NOT soak in a bath, hot tub, or swimming pool.
are all common complaints. To help ease and monitor your However, you may take a shower or sit in a few inches of
pain, do these things: warm water (“sitz bath”).

•• Take any medication as prescribed. Often your doctor Sexual intercourse
will prescribe medication to treat pain. Follow your
doctor’s instructions carefully. Don’t have sexual intercourse until your doctor
specifically says you may safely do so. Explain to your
•• CALL YOUR DOCTOR if you have: partner: to protect the healing, it’s important to check
–– Any increase in your pain, or if pain medication with the doctor before resuming sexual activity.
isn’t working
Physical activity and exercise
–– A lot of bloating or swelling in your abdomen
During your recovery, light activity is good for you.
–– Pain, redness, or swelling in one leg or in your groin It helps prevent problems such as gas, stiffness, weakness,
and blood clots. The trick is being active at the right level.
•• GET EMERGENCY CARE if you have chest pain, a cough Here are a few guidelines:
(not from a cold), or trouble breathing.
•• Take it easy for the first 2 weeks. This means:
Fatigue –– Don’t sit or stand for more than half an hour at a time.
–– Don’t push, pull, or strain.
Any surgery will leave you feeling tired. Your body is –– Don’t lift anything heavier than 5 pounds. And
healing. Try these tips to help speed the process: when you’re picking things up, bend carefully at the
knees and lift slowly.
•• Try to get at least 8 hours of sleep each night. –– Don’t do housework or yard work. Get your family
Rest throughout the day. to pitch in, or hire help.
–– You can drive as soon as your pain is gone and you
•• Eat well balanced, healthy meals. are NOT taking narcotics.
–– Take short walks several times a day. Ask someone
•• Tell your family what they can do to help you get for support if you feel shaky or dizzy. Start with
the rest you need. short distances, and work up to longer walks.

•• CALL YOUR DOCTOR if you become more tired •• Avoid climbing stairs if it hurts — but climb them as
(rather than less) each day, or if you’re dizzy for more soon as you can do so without pain.
than a few seconds at a time.
•• ASK YOUR DOCTOR when it’s okay to return to work
Infection or do more strenuous exercise. (Most patients can
return to work within 2 weeks.)
You don’t need to care for the incisions made in your
vagina. The internal stitches will dissolve on their own. Note: You don’t need to care for the incisions made in your
However, you must be alert to any signs of infection. vagina. The internal stitches will dissolve on their own. However,
do be alert to any signs of infection, such as fever or flu-like
•• CALL YOUR DOCTOR if you have any of these symptoms. Follow all the advice on this sheet about
symptoms: when to call the doctor.

–– Ongoing red bleeding from your vagina. 3
(It’s normal to have a small amount of bloody
discharge — but not red bleeding — at home.)

–– Fever of 100.4°F (38.0°C) or greater.

–– Flu-like symptoms (for example, chills, body
ache, fatigue, or headache).

–– Increase in pain, or pain medication that
isn’t working.

Gas Urination

Many women have gas after surgery. Here are some After surgery, you might have trouble urinating. This might
things to do to prevent or treat gas: be due to your surgery. But it may also come from pain
•• Walk more often or a little farther every day. medication, discomfort, or anxiety. Here’s what to do:

•• Stay away from carbonated drinks — and don’t use •• Don’t strain or bear down while going to the bathroom.
a straw. Drink warm drinks. This can damage the area of your recent surgery.

•• Lay on your left side, with your knees drawn up to •• Urinate while sitting in a few inches of warm water.
your chest. Or get on your knees and lean forward,
placing your weight on your folded arms with your •• Don’t let your bladder get too full. Believe it
buttocks in the air. or not, it’s easier if you urinate more often.

•• When you have gas, gently press on your abdomen •• Do Kegel exercises to strengthen the muscles around
every hour, following these steps: your vagina, bowel, and bladder. To start, tighten the
muscles you use to stop the flow of urine. Hold for a
1 Take a few deep breaths. Blow out slowly. count of ten, then relax the muscles slowly. Repeat
several times a day, working up to 100 Kegels a day.
2 Place your hands below your navel with the
fingertips touching. •• If you can’t urinate on your own before you leave
the hospital, you may need to go home with a urinary
3 Take a deep breath and hold it for 5 counts. catheter (a small tube to drain urine from the
bladder). Until you can urinate on your own, follow
4 Breathe out slowly and completely through these instructions:
your mouth while pressing in and down on
your abdomen. –– If you go home with a catheter in place,
follow the nurse’s instructions for caring for
5 Move your hands a half-inch and repeat steps the catheter and drainage bag. Do any exercises
2 to 4 several times, moving in a circle across you’ve been taught. And make sure you know when
your lower abdomen. and how the catheter will be removed.

•• CALL YOUR DOCTOR if you have continuing –– If you need to self-catheterize, a nurse will teach
or severe abdominal swelling or bloating. you how before you leave the hospital. Be sure to
self-catheterize as often as your nurse has told you
Constipation to — usually every 3 to 4 hours during the day.

Constipation after surgery can add to your discomfort. •• CALL YOUR DOCTOR if you:
Here’s what to do to prevent and relieve constipation: –– Can’t urinate, or have ongoing difficulty urinating

•• Drink at least 6 to 8 glasses of water each day. –– Have problems with your catheter, or with self-
catheterizing
•• Eat high-fiber foods. Fresh fruit, vegetables,
and whole grain bread are good options. –– Have bloody, cloudy, or foul-smelling urine

•• Don’t strain with bowel movements. –– Have burning, painful, or frequent urination

•• Take a stool softener or laxative if your doctor
recommends it. Do NOT use an enema.

•• CALL YOUR DOCTOR if you can’t relieve constipation
with the measures listed above.

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