Evaluation and management of rectoceles.
OBJECTIVE
As life expectancy increases, the prevalence of pelvic organ prolapse in general, and rectoceles, in particular, will continue to grow. The objectives of this article are to review the basic anatomy and contributing factors associated with the development of rectoceles and to discuss the appropriate work-up and treatment options.


RESULTS
The main themes in the current literature stress the importance of not only anatomic restoration, but also quality of life issues regarding visceral and sexual function when performing a rectocele repair. Many recent studies are also evaluating the role of preoperative adjunctive tests to better evaluate women with combined pelvic floor disorders, while others are looking at outcomes data regarding the various surgical approaches to repair a rectocele.


CONCLUSIONS
With significant advancements in pelvic anatomy over the last several decades the surgical approach to treating symptomatic rectoceles has evolved from the traditional posterior colporrhaphy with levator ani plication to the defect specific rectocele repair. While anatomic and overall functional outcomes have improved, one still needs to better define the correlation between defecatory dysfunction and a rectocele.
Segal
Jeffrey L
JL
Division of Urogynecology and Reconstructive Pelvic Surgery, Good Samaritan Hospital, Cincinnati, Ohio 45220, USA. Jeffreysegal@msn.com
Karram
Mickey M
MM
D003672:Defecation; D013505:Digestive System Surgical Procedures; D005260:Female; D006801:Humans; D010808:Physical Examination; D020047:Rectocele / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*; D012008:Recurrence; D013526:Surgical Mesh; D016896:Treatment Outcome