John Libbey Eurotext

Hépato-Gastro & Oncologie Digestive

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The rectocele: The ABCs of a complex subject… Volume 28, issue 10, Décembre 2021

Figures

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Tables

Authors
1 Groupe hospitalier Paris Saint-Joseph, Service de proctologie médico-chirurgicale, 185, rue Raymond Losserand, 75014 Paris
2 Groupe hospitalier Paris Saint-Joseph, Service de radiologie, 185, rue Raymond Losserand, 75014 Paris
3 Groupe hospitalier Paris Saint-Joseph, Service de gynécologie et d’obstétrique, 185, rue Raymond Losserand, 75014 Paris
4 Groupe hospitalier Paris Saint-Joseph, Département de kinésithérapie, 185, rue Raymond Losserand, 75014 Paris
5 Groupe hospitalier Paris Saint-Joseph, Service de chirurgie digestive, 185, rue Raymond Losserand, 75014 Paris
6 Groupe hospitalier Paris Saint-Joseph, Service d’Urologie, 185, rue Raymond Losserand, 75014 Paris
* Correspondance

Rectocele is a common condition consisting in a protrusion or herniation of the rectum into the posterior vaginal wall. It is most often asymptomatic. Otherwise, dyschezia and a bulge feeling in the vagina are the main symptoms. It is generally favored by constipation, vaginal deliveries, obesity, history of hysterectomy and tissue aging. It can be isolated or associated to other pelvic static disorders that should be systematically investigated. Indeed, their identification can change the therapeutic management. The treatment is largely medical and is essentially based on regularization of transit and on anoperineal rehabilitation by biofeedback. Surgical management is indicated in patients who have failed medical treatment or who suffer from cosmetic discomfort related to a large rectocele. It should at best be discussed in a multidisciplinary pelviperineology meeting which considers all the clinical and paraclinical data and the impact on the quality of life of this type of disorder. Indeed, the simple anatomical correction can in some cases not relieve or even worsen the symptoms. The patient must be well informed of the modalities and consequences of each proposed surgical procedure and must be involved in the therapeutic choice. Several surgical approaches are possible: transvaginal, transperineal, transanal and abdominal. But the abdominal approach by laparoscopic ventral rectopexy is by far the most widely used surgical procedure.