Posterior wall prolapse and repair

Area of Science:

• Gynecology
• Urogynecology
• Pelvic Floor Disorders

Background:

• Posterior wall defects, including rectoceles, frequently coexist with other pelvic support issues.
• Rectoceles can range from asymptomatic to causing significant pelvic fullness, defecatory, and sexual dysfunction.

Purpose of the Study:

• To review the current understanding and treatment of rectoceles.
• To evaluate the efficacy of surgical interventions for posterior wall defects.

Main Methods:

• Literature review of studies on rectocele diagnosis and management.
• Analysis of surgical outcomes for posterior compartment reconstruction.

Main Results:

• Conservative treatments like pelvic floor physiotherapy and pessaries are options for symptomatic rectoceles.
• Traditional posterior colporrhaphy demonstrates excellent cure rates, up to 95%.
• Current evidence does not support the use of biologic or synthetic absorbable grafts for posterior compartment repairs, as they offer no improvement over traditional methods.

Conclusions:

• Rectocele management involves conservative options for mild cases and surgical repair for persistent symptoms.
• Traditional posterior colporrhaphy remains the gold standard for surgical rectocele repair.
• Graft utilization in posterior compartment surgery is not recommended based on current scientific literature.