Rectocele-Enterocele Treatment
Rectocele-enterocele treatment, sagging that develops towards the back wall of the vagina as a result of weakening of the pelvic floor support; It is a treatment process planned according to the patient's complaints, the degree of sagging and its effect on quality of life.rectocele, bulging of the rectum towards the back wall of the vagina;enteroceleIt is the sagging of the small intestine towards the upper or back part of the vagina.
These two conditions can sometimes be seen alone; However, in many patients, cystocele may occur along with other pelvic organ prolapses, such as uterine prolapse or vaginal vault prolapse. The aim of treatment is not only to correct the anatomical appearance; It aims to reduce the feeling of pelvic pressure, relieve difficulty in defecation, control the complaint of vaginal fullness and increase the comfort of daily life.
“The decision in the treatment of rectocele and enterocele should be made not only according to the degree of prolapse, but also by evaluating defecation habits, pelvic pressure feeling, sexual life and the patient's daily quality of life.”
Article Summary
The issue of Rectocele-Enterocele Treatment should be addressed by evaluating the person's complaints, examination findings and needs together. In this article, the basic points about Rectocele-Enterocele Treatment, the diagnosis-treatment process and things to consider are summarized.
What Will You Find in This Article?
- What are Rectocele and Enterocele?:This section explains basic information on the subject, the evaluation process and points to consider.
- Why does rectocele-enterocele occur?:This section explains basic information on the subject, the evaluation process and points to consider.
- What are the Symptoms of Rectocele and Enterocele?:This section explains basic information on the subject, the evaluation process and points to consider.
- How is Rectocele-Enterocele Diagnosed?:This section explains basic information on the subject, the evaluation process and points to consider.
What are Rectocele and Enterocele?
rectocelePosterior vaginal wall prolapse occurs when the tissues supporting the posterior wall of the vagina weaken and the rectum bulges into the vagina.
In the evaluation of urinary incontinence and pelvic organ prolapse, the type of complaint, its impact on daily life, birth history and pelvic examination findings should be considered together [1][2].
enteroceleIt is when the small intestine descends towards the lower pelvis and puts pressure on the upper or back part of the vagina.
In both cases, the symptoms felt by the patient may be similar: vaginal fullness, a feeling of being pulled down, pelvic pressure, straining during defecation, and discomfort during sexual intercourse.
Why Does Rectocele-Enterocele Occur?
The basic mechanism in the formation of rectocele and enterocele is the weakening of the pelvic floor muscles and connective tissues over time. Vaginal birth, aging, decreased tissue elasticity after menopause, excess weight, chronic constipation, constant straining, chronic cough, heavy lifting and previous pelvic surgeries can accelerate this process.
The treatment plan is not the same for every patient; Lifestyle adjustments, pelvic floor exercises, pessary, medication or surgical options are evaluated individually [1][3].
Factors that can contribute to the development of rectocele and enterocele include:
- History of vaginal birth or difficult birth,
- Having given birth to many births,
- Weakening of tissues after menopause,
- Chronic constipation and frequent straining,
- Excess weight and increased intra-abdominal pressure,
- chronic cough,
- Heavy lifting habit
- Previous hysterectomy or pelvic floor surgeries,
- Genetic predisposition to connective tissue weakness.
Enterocele may become more noticeable, especially in patients who have had a previous hysterectomy or whose vaginal vault support is weakened. In rectocele, constipation, straining during defecation and bowel habits are especially important in the treatment plan.
What are the symptoms of rectocele and enterocele?
The most important factor in deciding on rectocele-enterocele treatment is often the symptoms. Mild sagging may not cause symptoms. In moderate and severe prolapse, fullness in the vagina, a palpable mass sensation, pelvic pressure and difficulty in defecation may be more evident.
If a surgical decision is to be made, the patient's expectations, degree of prolapse, sexual life, accompanying urinary incontinence and risk of recurrence should be discussed together [1][2].
Symptoms of rectocele and enterocele include:
- A feeling of fullness or pressure inside the vagina,
- Palpable bulge on the back wall of the vagina,
- Feeling of being pulled down,
- Pelvic discomfort that increases when standing for long periods of time,
- Difficulty during defecation,
- Feeling of not being able to fully evacuate the stool,
- Constipation and the need to strain frequently,
- Pressure, pain or discomfort during sexual intercourse,
- Feeling of pressure in the waist or groin area,
- Accompanying urinary incontinence or difficulty urinating.
How is Rectocele-Enterocele Diagnosed?
Diagnosis is usually made by detailed history and gynecological examination. During the examination, the back wall of the vagina, pelvic floor support and other accompanying sagging are evaluated. The degree of sagging can be seen more clearly by asking the patient to strain or cough.
If there is an increase in complaints, bleeding, pain, or new onset of urinary problems during the follow-up period, re-evaluation is required [3].
While only examination is sufficient for some patients, additional examinations may be required if there is difficulty in defecation, urinary problems, a history of previous surgery or suspicion of multiple prolapses. The treatment plan is not just based on "there is sagging"; It should be prepared according to whether the prolapse causes symptoms or not.
How to Plan Rectocele-Enterocele Treatment?
Rectocele-enterocele treatmentIt is planned according to the degree of sagging, the patient's complaints and its impact on quality of life.
The following points are taken into account in the treatment plan:
- Whether the sagging is mild, moderate or severe,
- The feeling of vaginal fullness and pressure affects daily life,
- Presence of constipation and difficulty in defecation,
- habit of straining,
- Whether there is any discomfort during sexual intercourse,
- Accompanying problems such as urinary incontinence or cystocele,
- The patient's desire for surgery or suitability for surgery,
- Previous pelvic surgeries.
Non-Surgical Rectocele-Enterocele Treatment
Non-surgical treatment can be considered as the first step, especially in mild and moderate cases. The aim is to slow the progression of prolapse, reduce pelvic pressure, control constipation and improve quality of life.
Non-surgical treatment options include:
- Pelvic Floor Exercises:Kegel exercises and pelvic floor physiotherapy can help strengthen supporting tissues.
- Regulation of Constipation:A fiber-rich diet, adequate fluid intake, and reducing straining can especially alleviate rectocele symptoms.
- Bowel Training:It is important to regulate toilet habits and avoid unnecessary straining.
- Weight Control:Excess weight can increase the load on the pelvic floor.
- Vaginal Pessar:Sagging tissues can be supported mechanically with a support device placed inside the vagina.
When is Surgery Necessary in the Treatment of Rectocele-Enterocele?
Surgical treatment may be considered in the following cases:
- Significant fullness or bulging of the vagina,
- Difficulty defecating impairs quality of life,
- Constant straining and the feeling of not being able to ejaculate completely,
- Significant discomfort during sexual intercourse,
- Insufficient benefit from non-surgical methods,
- Presence of accompanying uterine prolapse, cystocele or vaginal dome prolapse,
- Feeling of pelvic pressure and heaviness that disrupts daily life.
What is done in rectocele-enterocele surgery?
The main purpose of rectocele surgery is to strengthen the weakened support tissue between the vagina and rectum and to reduce the bulge in the back wall of the vagina. During surgery, loosened tissues can be recovered, supporting tissues can be strengthened with stitches, and excess tissue can be removed if necessary.
The surgical approach to enterocele is aimed at restoring support in the area where the small intestine sags. The operation can be planned via vaginal, laparoscopic or abdominal approach. Which technique is appropriate; The type of prolapse is determined by other accompanying prolapses, previous surgeries and the general health condition of the patient.
Methods Used in Rectocele-Enterocele Treatment
| Treatment Method | Who Is More Suitable? | Main Purpose |
|---|---|---|
| Tracking and lifestyle adjustment | In patients with mild sagging and no obvious complaints | Slowing down the progression of sagging and reducing the occurrence of complaints |
| Pelvic floor exercises | In patients with mild to moderate symptoms | Strengthening pelvic muscle support |
| Constipation treatment and bowel regulation | Especially in those who have difficulty defecating with rectocele | Reduce straining and provide symptom control |
| vaginal pessary | In patients who do not want surgery or are not suitable for surgery | Mechanically supporting sagging |
| surgical repair | In patients with advanced symptoms or who do not benefit from conservative treatment | Restoring anatomical support and improving quality of life |
What to Pay Attention to During the Post-Surgery Process?
Things to consider after surgery:
- Do not lift heavy objects for the period recommended by the doctor,
- Avoiding constipation and avoiding straining,
- Drinking plenty of fluids and eating fiber,
- Waiting for the time recommended by the doctor for sexual intercourse,
- Avoiding environments that may pose a risk of infection, such as swimming pools, Turkish baths and bathtubs,
- Not disrupting control appointments,
- See a doctor in case of fever, foul-smelling discharge, heavy bleeding, severe pain or inability to urinate.
Will it recur after rectocele-enterocele treatment?
Yes, pelvic organ prolapse may recur over time after treatment. Risk of recurrence; It is affected by factors such as connective tissue structure, age, menopause, chronic constipation, constant straining, excess weight, chronic cough and heavy lifting.
To reduce the risk of recurrence, it is important to control constipation, reduce straining, manage weight, treat chronic cough, and continue pelvic floor exercises. Maintaining bowel regularity, especially in rectocele treatment, is important for long-term success.
Rectocele-Enterocele Treatment Prices 2026
Rectocele-enterocele treatment prices; It may vary depending on the degree of prolapse, non-surgical or surgical planning of the treatment, whether a vaginal pessary is required, the scope of the surgery, the type of anesthesia, hospital conditions, and whether there is accompanying cystocele, uterine prolapse or urinary incontinence treatment.
The most accurate information about current rectocele-enterocele treatment prices in 2026 can be given after examination and personal evaluation. Because each patient's degree of sagging, complaints and treatment needs are different.
Frequently Asked Questions
No. Rectocele is the bulging of the rectum towards the back wall of the vagina. Enterocele is the prolapse of the small intestine towards the upper or back part of the vagina. However, the two can be seen together.
In mild and moderate cases, non-surgical treatment may be possible with pelvic floor exercises, constipation treatment, lifestyle adjustments and vaginal pessary.
No. If the sagging is mild and the patient does not experience significant discomfort, follow-up and lifestyle adjustments may be sufficient. Surgery is usually considered if complaints are significant.
Because chronic constipation and straining increases the pressure on the pelvic floor. This may worsen complaints and increase the risk of recurrence after treatment.
Pessar is a support device placed inside the vagina. It can help reduce the feeling of pressure and fullness by providing mechanical support to sagging tissues.
Yes, some patients may develop sagging again over time. Preventing constipation, avoiding heavy lifting, weight control and pelvic floor exercises can help reduce the risk of recurrence.