Understanding Rectocele

[x]   Tags: Rectocele Rectum, Vagina, Vaginal Pressure, Fascia, Levatorplasty, Constipation, Heavy Lifting, Pessary : Vaginal Surgery, Reproductive Surgery, Women's Health, Vaginal Health, Reproductive Health: Health, Health Video, Medical Videos, Medical, Video

[x]   Transcript: You may be unacquainted with the term 'rectocele,' but for almost 19% of women, the condition is all too familiar! In a normal female pelvis, the rectum rests behind the vagina. The two are separated by a thin wall of fibrous tissue called fascia. When the fascia becomes weakened or damaged, the front of the rectum can bulge into the vagina. This is known as a rectocele. Past pregnancies and childbirth, as well as the natural aging process, are the most common causes. But other factors can contribute to weakening of this fascia, too, including: constipation or straining with bowel movements, chronic cough or bronchitis, repeated heavy lifting, and being overweight or obese. Whatever the cause, rectoceles may induce a sensation of rectal pressure or fullness. Difficulty having bowel movements and a feeling that the rectum has not fully emptied afterwards are also common. Severe rectoceles may even become visible, appearing as a bulge of tissue that might protrude through the vagina. For more mild cases of rectocele, a vaginal pessary may effectively treat the problem. Pessaries are removable support devices that hold the rectum in place. More often than not, though, treatment for rectocele requires surgery, The most common is a levatorplasty, which utilizes sutures to bring the inside edges of the levator ani, or Kegel, muscles together. This method works because the levator muscles support the entire pelvic floor like a sling, and they can pull apart with a rectocele. Recently though, levatorplasty has undergone scrutiny for potentially causing pelvic pain. Knowing this, some doctors choose to do a newer procedure called site-specific rectocele repair, which uses sutures to close ONLY the holes in the connective fascia tissue, bypassing the levator muscles completely. Although LESS likely to cause pain, site-specific rectocele techniques are MORE likely to cause recurrence of the problem. Because each procedure has its good and bad points, it's important to discuss the best rectocele repair for YOU with your surgeon.

[x]   Bio: Dr. Lauri Romanzi is a reconstructive pelvic surgeon, urogynecologist and clinical associate professor at Weill/Cornell New York Presbyterian Hosptial in New York City. Her urogynecologic research includes prolapse, incontinence, overactive bladder, Kegel fitness scoring, genital sensitivity nerve testing and fistula repair. Her 2009 book Plumbing and Renovation: If you have a uterus or know someone who does, this book is for you provides the lay public with a review on pelvic organ prolapse, urinary incontinence and pelvic floor fitness.

Dr. Romanzi has been a featured expert on the Today Show, The Dr. Oz Show and Good Morning America. Additional media credits include: NY Times, Fox 5, London Guardian, More Magazine, Redbook, Oprah Magazine, Telemundo, Radio Ritas, Dr. Radio, Cosmo Radio, London Times, Playboy Radio and Italian Playboy.

Dr. Romanzi advises women with pelvic floor disorders who cannot travel to New York through her blog (www.urogynics.org/blog – ask Dr R feature). In 2008 she opened PHIT, the world's first medical spa devoted to Kegel -focused feminine rejuvenation (www.theperfectphit.com ).

Dr. Romanzi's international work with Harvard Humanitarian Initiative, Surgeons Over Seas and other international groups includes teaching and volunteer surgery for women suffering childbirth injury and war trauma in Niger, Tanzania and the Democratic Republic of Congo.