For many women, the delivery process is associated with injuries and a variety of pathologies. One of them is rectocele. What it is?
general information
Rectocele is a common disease characterized by a protrusion of the rectal wall into the vagina. This pathology is accompanied by constipation and a violation of the bowel movement. Rectocele is one of the manifestations of pelvic muscle weakness in women. With severe protrusion, when treatment with diet and drugs is ineffective, surgical intervention is required.
According to statistics, over the past few years, the incidence of rectocele has increased significantly. Most of the patients are women giving birth over 45 years old. In our country today, little attention is paid to this disease. Often, women have to go around several specialists to find a qualified doctor who deals with pelvic prolapse and rectocele.
What is this disease?
Among the main reasons for the development of pathology, doctors call the weakness of the muscles and ligaments of the pelvic floor. In the process of delivery, the perineum experiences tremendous stress. The soft tissues of the pelvis are gradually stretched. Many women already at this time begin to form their rectocele. With age, the strength of the muscles of the pelvic floor disappears. The septum between the intestine and the vaginal area becomes very thin. The supporting parts of the perineum cannot fully support it. During each act of defecation, the rectum begins to tumble into the vaginal area.
The protrusion of the front wall of the organ gradually increases. Pathology takes the form of a bag that can hang outward from the vagina. Against the background of these changes, the process of defecation is disrupted, the stool is delayed in protrusion. A woman is forced to push even harder. As a result, the size of the rectocele increases exponentially, constipation occurs. Thus, a vicious circle is formed.
Sometimes rectocele disease is combined with rectal prolapse. The walls of the lower organ begin to protrude forward, forming a bag. Above it a dropping out mucous membrane may hang. In this case, the rectum develops accordion. Such serious changes cause a violation of the act of defecation and require surgical intervention.
How to independently determine the rectocele?
Symptoms of the disease appear gradually. They do not threaten life, so many are in no hurry to seek help from a doctor. The first sign of pathology is prolonged constipation. In this case, patients note normal urge to the toilet, but it is very difficult to empty the intestines. They are concerned about the heaviness in the anus and the feeling of the presence of a foreign body.
Many women at this stage of the development of the disease are unaware of serious violations. They prefer to use laxatives or cleansing enemas. After some time, there is a need for manual benefits during bowel movements. Intense straining leads to trauma to the mucosa of the anal canal. As a result, concomitant proctological ailments develop (chronic hemorrhoids, fistulas, anal fissures), which cannot be cured at home. Stagnation of feces sometimes contributes to the formation of inflammatory changes, which are accompanied by fever and intoxication syndrome.
Classification of the pathological process
The disease belongs to the group of slowly ongoing surgical pathologies. Depending on the prevalence of certain pathomorphological disorders, three degrees of rectocele are distinguished. Each of them is characterized by a characteristic clinical picture.
- Rectocele of the 1st degree is very rare. Pathology is usually detected by chance during a routine examination. There are no characteristic symptoms of the disease.
- Rectocele of the 2nd degree is distinguished by a detailed clinical picture. Patients complain of discomfort in the perianal region, problems with bowel movements.
- Grade 3 rectocele is characterized by prolapse of the intestine beyond the vaginal canal. Patients at the same time suffer from fecal incontinence, constipation. Sexual contact is accompanied by painful discomfort.
There is also a diagnostic classification of rectocele. What it is? Depending on the results of radiation imaging methods, certain categories of pathology are distinguished. For example, protrusion of up to 20 mm is considered minimal. Critical parameters are from 40 mm or more.
Medical examination
Diagnosis of rectocele (a photo of the pathology is presented at the beginning of the article) usually does not cause difficulties. If this disease is suspected, a proctological examination is required. During a physical examination, the doctor evaluates the size of the protrusion, its position relative to other internal structures.
To clarify the diagnosis, especially when surgery is planned, a more serious examination is necessary. First of all, they appoint defecography. This study allows you to study the defecation process in real time. To do this, a rubber tube with a can is inserted into the rectum. Then it is filled with a mushy mass, which is clearly visible on x-ray. The woman is seated on a special chair and asked to push, as in the act of defecation. The doctor monitors all this process with the help of an X-ray screen.
It is mandatory to diagnose not only the anatomy, but also the functions of the pelvic floor organs. For this, anorectal manometry is performed. Such a study allows us to determine the strength of the perineal muscles and disorders in their work. Sometimes anorectal manometry dramatically changes the preliminary treatment plan.
Traditional therapy
Treatment of rectocele in the initial stages of development involves the use of conservative methods of therapy. They are designed to normalize the functioning of the intestines and eliminate associated inflammatory diseases. For these purposes, a variety of drugs are used: osmotic laxatives, prokinetics, eubiotics. The doctor should prescribe the drugs, taking into account the general condition of the patient and the results of the diagnostic examination.
It is necessary to begin treatment with rectocele with the regulation of bowel function. To do this, it is recommended to replace the usual diet with a more strict diet. It is advisable to eat fiber-rich foods (vegetables). Drinking regimen also requires adjustment. It is recommended to drink at least two liters of pure water per day. How it works? Fiber and liquid increase the volume of feces, making their texture softer. As a result, feces move freely through the intestines and exit faster.
Surgical intervention
The most effective rectocele treatment is surgery. Reviews of many doctors indicate that resorting to surgical intervention is necessary with the second and third degree of development of the pathological process.
The essence of the operation is to eliminate the protrusion of the intestine, fixing its front wall and strengthening the rectovaginal septum. Surgical access to the affected area can be obtained through the vagina, perineum or abdominal cavity. With severe pathological changes in the localization of the pelvic organs or concomitant ailments (hemorrhoids, anal fissure), a combined surgical intervention is performed. It implies a simultaneous correction of background diseases.
Endoscopic treatment of rectocele is also used in medical practice. Reviews about this method of surgical intervention in most cases are positive. In addition to eliminating defects, the doctor installs a mesh implant during surgery. It is made of inert materials, which reduces the risk of allergies and infectious complications. Modern technology helps to align implants with high accuracy. Their use allows you to strengthen the rectovaginal zone and ligaments of the small pelvis. After such an operation, patients in two days return to their usual way of life.
Help traditional medicine
Folk doctors know how to treat rectocele. However, unconventional therapy cannot be considered effective, and its help should be resorted to only at the initial stage of the disease. With traditional medicine recipes, it is not recommended to replace the treatment prescribed by a doctor. They do not eliminate the cause of the disease, but help to reduce the manifestation of its symptoms.
- Vegetable oil is considered an excellent remedy for constipation. It is recommended to drink it on an empty stomach twice a day, one tablespoon each.
- Buckwheat porridge is no less useful for problems with bowel movements. To prepare it, you need to soak four tablespoons of cereal in 350 ml of kefir, leave it overnight. In the morning, cooked porridge can be eaten for breakfast, and after that do not drink or eat anything for an hour. This food facilitates the evacuation of feces due to their dilution.
- To normalize the stool and strengthen the walls of the intestine, it is useful to drink beetroot juice with honey (1: 1 ratio).
Disease prevention
Rectocele is considered one of the most unpleasant diseases. What is this ailment can be understood from the materials in this article. How to prevent its occurrence?
First of all, doctors advise to monitor the work of the digestive tract. It is necessary to avoid overeating, to prevent constipation. To do this, you should limit the use of irritating gastrointestinal tract products, as well as observe a diet. Physical activity must be constantly monitored. To prevent rectocele, you can perform exercises aimed at strengthening the muscles of the pelvis and perineum. They should be selected with an instructor in physiotherapy.