What Is Posterior Prolapse Repair?

Jillian O Keeffe

A posterior prolapse repair is a type of surgery that involves the vagina and the rectum. In women, the rectum is located next to the vaginal entrance, and normally these are kept apart by a structural wall of tissue. If this wall becomes weak, something that happens often after childbirth, the rectum can push into the vaginal space and cause discomfort. A surgeon can perform repair surgery that strengthens the wall between the two areas, by removing some of the vaginal tissue that has become stretched, and stitching up the dividing wall to give it more strength.

Posterior prolapse repair is used to address a rectum which is pushing against the vagina.
Posterior prolapse repair is used to address a rectum which is pushing against the vagina.

Various parts of the body are kept in distinct positions by structural tissues. This is the case for the vaginal entrance and the rectum, which are on one side of a tissue divider. This divider is normally strong enough to hold the vagina and rectum apart. A posterior prolapse occurs when the divider is not strong enough to hold the mass of the rectum apart from the vagina, and the back wall of the vagina falls inward, in a bulge.

As having children can result in permanent stretching of the sides of the vagina, this is the cause of the majority of cases of posterior prolapse. Typically, a woman does not have any noticeable problems until she gets to the menopause, and the posterior prolapse usually occurs after this age. Then she may experience a sensation of still needing to go to the toilet even though she already has emptied her bowels, and be aware of the presence of abnormal tissue in the vagina. Women who carry too much body weight or who cough frequently tend to be more prone to a posterior prolapse than other women.

Before the surgical treatment option, a doctor may recommend physical therapy to some women with mild prolapses. Constipation can also affect the discomfort of a prolapse and once the constipation is treated, surgery may not be necessary. For other cases, surgery is commonly used to fix the prolapse.

The surgeon makes an incision in the back wall of the vagina and then moves the rectal tissue back into its normal place. He or she then puts some stitches into the wall between the vagina and the rectum to make it more supportive. As the back wall of the vagina typically is stretched, the surgeon also removes some of the extra tissue to make the vaginal wall stronger. The surgery is usually quick, taking about 30 minutes, and the patient receives a general anesthetic.

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