Posterior Repair

Posterior repair is a surgical procedure used to correct defects in the posterior wall of the vagina, which is the back wall of the vaginal canal. This type of surgery is often performed to treat conditions such as rectocele, enterocele, and vaginal prolapse.

What is Rectocele?

A rectocele occurs when the thin wall of tissue that separates the vagina from the rectum (the posterior vaginal wall) weakens or tears, allowing the rectal lining to bulge into the vagina. This can cause symptoms such as difficulty emptying the bowels, constipation, and a feeling of incomplete evacuation.

What is Enterocele?

An enterocele occurs when the intestine bulges into the vagina, often through a weakness in the posterior vaginal wall. This can cause symptoms such as pelvic pressure, discomfort, and difficulty emptying the bowels.

Vaginal Prolapse

Vaginal prolapse occurs when the muscles and tissues that support the vagina weaken, allowing the vagina to bulge or sag. Posterior repair is often performed in conjunction with other surgical procedures to treat vaginal prolapse.

Surgical Procedure

Posterior repair surgery typically involves the following steps:

• The patient is given general anesthesia or regional anesthesia to numb the lower part of the body.
• An incision is made in the posterior wall of the vagina, and the surgeon gently separates the rectal lining from the vaginal tissue.
• The weakened or damaged tissue is repaired using sutures or mesh material.
• The rectal lining is reattached to the posterior vaginal wall, and any excess tissue is removed.
• The incision is closed with sutures, and the area is packed with gauze to promote healing.

Types of Posterior Repair

There are several types of posterior repair surgery, including:

• Traditional posterior colporrhaphy: This involves repairing the posterior vaginal wall using sutures or mesh material.
• Site-specific repair: This involves repairing specific areas of weakness in the posterior vaginal wall.
• Biological graft repair: This involves using biological graft materials, such as donor tissue or xenografts, to reinforce the posterior vaginal wall.

Risks and Complications

As with any surgical procedure, there are risks and complications associated with posterior repair surgery. These may include:

• Bleeding or hemorrhage
• Infection
• Damage to surrounding tissues or organs
• Adhesions or scarring
• Dyspareunia (painful intercourse)
• Vaginal narrowing or stenosis

Recovery and Aftercare

After posterior repair surgery, patients typically require several weeks of recovery time. During this period, they may need to:

• Avoid heavy lifting, bending, or straining
• Avoid sexual intercourse for several weeks
• Use pain medication as directed by the surgeon
• Attend follow-up appointments with the surgeon to monitor healing and remove any sutures or packing.

Success Rates

The success rate of posterior repair surgery varies depending on the individual case and the type of procedure performed. However, studies have shown that:

• Traditional posterior colporrhaphy has a success rate of around 70-80%
• Site-specific repair has a success rate of around 80-90%
• Biological graft repair has a success rate of around 90-95%

Conclusion

Posterior repair surgery is a effective treatment option for women with rectocele, enterocele, and vaginal prolapse. While there are risks and complications associated with the procedure, the success rates are generally high, and many women experience significant improvement in their symptoms and quality of life.