Symptoms of posterior wall weakness typically entail pelvic and perineal pressure, a vaginal bulge, and associated lower back pain. Many women need to digitally reduce or splint the posterior vaginal bulge or the perineum to initiate or complete a bowel movement. Accumulation of stool within the rectocele reservoir leads to increasing degrees of perineal pressure and obstructive defecation. In the absence of digital reduction, women will note incomplete emptying, which leads to a high degree of frustration. A vicious cycle of increasing pelvic pressure, need for stronger Valsalva efforts, enlargement of the rectocele bulge, and increasing perineal pressure ensues. Rectal dig-itation is frequently not self-reported by patients with a symptomatic rectocele unless asked by their physicians.

An enlarging rectocele will widen the levator hiatus and increase vaginal caliber. In addition, women with increasing degrees of prolapse have progressively larger genital hiatuses.4 This may lead to sexual difficulties including symptoms of vaginal looseness and decreased sensation during intercourse. Whether this is caused by the enlargement of the vaginal introitus and levator hiatus, or coexistent damage to the pudendal nerve supply to the pelvic floor musculature is unclear. A large enterocele or rectocele may extend beyond the hymenal ring. Once exteriorized, the patient is at risk for vaginal mucosal erosion and ulceration.

Patients frequently have associated complaints of constipation. The symptom of constipation is not clearly understood by the practicing gynecologist. Its vague nature, coupled with a poor understanding of the complexity of colonic function, results in an incomplete evaluation of the symptom of constipation by the gynecologist. Unfortunately, this may result in surgical treatment of abnormal bowel function via a rectocele repair when conservative therapy for constipation may have been satisfactory. The persistence of abnormal defecation postoperatively may be responsible for the high rectocele recurrence rate.

Constipation Prescription

Constipation Prescription

Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.

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