Posterior Vaginal Repair (Rectocele Repair)

Posterior colporrhaphy repairs a rectocele, a bulge of the rectum into the back wall of the vagina caused by weakening of the supporting tissue between them, most often after childbirth. The surgeon tightens this layer with stitches through the vagina and usually rebuilds the perineal body at the vaginal entrance.

It relieves the sensation of a lump, and in most women the need to press on the vagina or perineum to empty the bowel. It does not cure constipation from a slow bowel, and tightening too much can cause pain during sex.

What Posterior Vaginal Repair (Rectocele Repair) involves

With your legs in supports, the surgeon injects local anaesthetic with adrenaline under the back wall of the vagina to reduce bleeding, then makes a midline cut from the entrance towards the top. The vaginal skin is lifted off the underlying rectovaginal fascia on each side. A finger in the rectum helps identify the weakness. In a traditional repair, the fascia is folded together in the midline with a row of dissolvable stitches; in a site-specific repair, only the individual tears in the fascia are closed. Excess vaginal skin is trimmed conservatively and the wall is closed. The separated perineal muscles are then brought together (perineorrhaphy). A vaginal pack and catheter may be left overnight.

Who is a good candidate for Posterior Vaginal Repair (Rectocele Repair)?

Surgery is for women with a bothersome bulge or emptying difficulty after conservative measures have been tried.

• A symptomatic rectocele reaching or passing the vaginal opening
• Needing to support the perineum or vaginal wall with a finger to pass stool
• A widened, gaping vaginal entrance after childbirth tears, causing discomfort or reduced sensation
• Women having other prolapse surgery in whom the back wall also needs support
• Symptoms that persist after pelvic floor physiotherapy, bowel management or a pessary trial

It is usually not the right choice if:

• A rectocele found on examination that causes no symptoms
• Constipation from slow transit or pelvic floor muscles that fail to relax, which need bowel investigations first
• Women planning a vaginal birth in the future
• Existing pain with intercourse or pelvic pain syndromes, which surgery may aggravate
• Active vaginal infection or untreated atrophy, which should be corrected beforehand

Technique options

• Midline fascial plication: The standard native-tissue repair, with anatomical success of about 80 to 90 percent.
• Site-specific repair: Closes discrete defects only; slightly higher recurrence but less narrowing.
• Perineorrhaphy: Rebuilds the perineal body; nearly always combined.
• Transanal repair or ventral rectopexy: Performed by colorectal surgeons when there is also internal rectal prolapse.
• Vaginal pessary: A non-surgical alternative that suits women who wish to avoid or postpone an operation.

What happens during your treatment

The operation takes 45 to 75 minutes under general or spinal anaesthesia. You stay one night, sometimes two. The pack and catheter are removed the next morning. Perineal soreness when sitting is the main complaint and is controlled with regular tablets and ice packs. The first bowel movement is eased with stool softeners.

Preparing for your trip

Plan for 7 to 10 days in Istanbul. Your surgeon reviews photographs and your medical history before you book, and you meet in person the day before surgery for examination, marking and consent with a professional interpreter.

• Stop smoking and nicotine at least four weeks before and after surgery; it is the single biggest avoidable cause of wound problems
• Tell the team about every medicine and supplement you take; blood thinners, some herbal products and hormone treatment may need to be paused on your doctor's advice
• Arrange for someone to travel with you or to be reachable, and keep the first days at home free of work and lifting
• Book a changeable return flight; your surgeon confirms when you are fit to fly

Recovery and results

Expect vaginal discharge with dissolving stitch fragments for 3 to 6 weeks. Take laxatives daily for 6 weeks and do not strain. Avoid lifting above 5 kilograms, high-impact exercise, tampons and intercourse for 6 weeks. Desk work is reasonable at 2 to 3 weeks. Vaginal oestrogen cream is often advised after the menopause to help healing. Long-term, avoiding constipation and heavy lifting protects the repair.

• Back to everyday activity: 2 to 3 weeks; 6 weeks of restrictions
• When results show: Bulge corrected immediately; comfort improves over 6 weeks
• How long they last: Long-lasting in about 80 percent

Safety, risks and revision policy

It is a low-risk operation, but it is performed in a sensitive area, and the balance between support and tightness matters.

• Pain during intercourse from narrowing or scar tissue, in roughly 5 to 15 percent
• Recurrence of the bulge over the years
• Bleeding or a haematoma in the vaginal wall
• Wound infection or stitch granulomas causing discharge
• Difficulty passing urine for a few days
• Injury to the rectum, which is rare and repaired at the time
• Persistent bowel-emptying difficulty if the cause was not the rectocele alone

Every written proposal arranged through Clinic-Y states what the clinic covers if a correction is needed. Ask for it before you book, not after.

Cost of Posterior Vaginal Repair (Rectocele Repair) in Türkiye

Clinic-Y does not publish a single price for Posterior Vaginal Repair (Rectocele Repair), because the honest figure depends on your case. What moves it:

• Whether it is combined with anterior repair, hysterectomy or a continence procedure
• Anaesthesia type and nights in hospital
• Pre-operative tests such as a defaecating proctogram
• Surgeon's urogynaecology experience
• Follow-up physiotherapy

Send your photographs or reports and you receive written, all-inclusive proposals from suitable teams, side by side. Reviewing your case is free.

Frequently Asked Questions