Transvaginal rectocoele repair and levatorplasty

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

The risk of developing a rectocoele can be increased by:

  • vaginal childbirth
  • long-term (chronic) constipation
  • heavy lifting

A levatorplasty is a type of surgery where the pelvic floor muscles are stitched together. This strengthens the space between the anus and the vagina, and should prevent your rectocoele from happening again.


Your doctor may recommend levatorplasty surgery to fix your rectocoele, especially if it causes symptoms such as:

  • bulging that causes pain and discomfort in the vagina
  • difficultly having a poo
  • a feeling of pressure or ‘fullness’ in your bowels, even when you have just had a poo
  • not able to control your bowel movements or more poo coming out after opening your bowels

Alternative treatments

You are seen in the bowel function clinic before we consider the option of surgery. 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 incontinence 

You can also try rectal irrigation, a specialist treatment used for ongoing (chronic) constipation and bowel incontinence.


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 rectocoele repair and levatorplasty include:

  • the repair fails so the rectocoele returns
  • injury to the anus or nearby organs
  • sex may feel different and may be painful
  • infection due to an ano-vaginal fistula (connection between the anus and vagina)

We want to involve you in decisions about your care and treatment. If you decide to have surgery, you will be asked to sign a consent form to say that you agree to have the treatment and you 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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Contact us

If you have any questions or concerns about your operation, please contact pelvic floor unit.

Phone: 020 7188 4191 and ask to speak to a clinical nurse specialist, Monday to Friday, 9am to 5pm

Email: pelvicfloor[email protected]

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Do you have any comments or concerns about your care?

Contact our Patient Advice and Liaison Service (PALS)

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