Urogynecological Assessment and Perspective in Patients Presenting with Evacuatory Dysfunction

  • Jennifer T. Pollak
  • G. Willy Davila


The gynecologic indications for enterocele and rectocele repair are more numerous compared with the traditional colorectal indications because gynecologists primarily address vaginal symptoms when repairing a rectocele. Here, obstructive defecation symptoms are only some of a list of accepted indications. Preoperative evaluation typically only includes clinical assessment gained from the history and physical examination, and gynecologists rarely depend on defecography to plan a reconstructive procedure for rectoceles. Overall, surgical correction success rates are quite high when using a vaginal approach for rectocele correction. Vaginal dissection results in better visualization and access to the endopelvic fascia and levator musculature, which allows for a “firmer” anatomic correction. In addition, maintaining rectal mucosal integrity appears to reduce the risk of postoperative infection and fistula formation. More comprehensive data collection is necessary to better understand the effect of various surgical techniques on vaginal, sexual, and defecatory symptoms in these patients who may present with complex symptomatology where the rectocele and/or enterocele represent the dominant clinical finding.


Pelvic Organ Prolapse Uterosacral Ligament Posterior Vaginal Wall Perineal Body Genital Prolapse 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Springer-Verlag London Limited 2005

Authors and Affiliations

  • Jennifer T. Pollak
    • 1
  • G. Willy Davila
    • 1
  1. 1.Department of Gynecology, Section of Urogynecology and Reconstructive Pelvic SurgeryCleveland Clinic FloridaWestonUSA

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