Transvaginal rectocele repair and levatorplasty

A rectocele is a bulging of the anus (bottom) into the vagina. It happens when the tissues that separate the anus and vagina are weakened.

Some things can increase the chance of getting a rectocele, such as:

  • vaginal childbirth
  • long-term (chronic) constipation (when you find it hard to poo or go to the toilet less often than usual)
  • heavy lifting

A levatorplasty is a type of surgery where we stitch the pelvic floor muscles together. This strengthens the space between the anus and the vagina. It prevents your rectocele from happening again.

Symptoms of a rectocele

Your doctor may recommend levatorplasty surgery to fix your rectocele, especially if it causes symptoms like:

  • bulging that causes pain and discomfort in the vagina
  • difficultly doing a poo
  • a feeling of pressure or ‘fullness’ in your bowels, even when you have just done a poo
  • problems with controlling your bowels (you may have sudden urges to poo that you cannot control or more poo may leak out after you have already done a poo)

Other treatment options

You have an appointment in the bowel function clinic before we think about if surgery is a suitable option for you.

A nurse specialist or a specialist physiotherapist can show you some techniques, including:

  • different ways of going to the toilet
  • pelvic floor exercises
  • ways of having a poo to avoid discomfort or bowel incontinence (problems with controlling your bowels)

You can also try rectal irrigation. This is a specialist treatment for ongoing (chronic) constipation and bowel incontinence. You do the treatment yourself while sitting on the toilet. Using a small tube, you pass warm tap water through your bottom into your lower bowel to flush out any poo.

Risks of surgery

All surgery has some risks, including:

  • infection
  • blood clots in your legs or lungs
  • bleeding during or after surgery

The risks of surgery for a rectocele repair and levatorplasty include:

  • failure of the repair, which can make the rectocele return
  • injury to the anus or nearby organs
  • pain during sex
  • infection because of an ano-vaginal fistula (an abnormal connection between the anus and vagina)

We want to involve you in decisions about your care and treatment. If you decide to have surgery, we ask you to sign a consent form. This says that you agree to have the treatment and understand what it involves.

If you would like more information about our consent process, speak to a member of staff caring for you.

Resource number: 3845/VER3
Last reviewed: April 2022
Next review: October 2023

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