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Rectocele

MedGen UID:
57445
•Concept ID:
C0149771
•
Acquired Abnormality; Finding
Synonyms: Proctocele; Proctoceles; Rectoceles
SNOMED CT: Herniation of rectum into vagina (447072005); Rectovaginal prolapse (447072005); Rectovaginal hernia (447072005); Female rectocele (447072005); Female proctocele (447072005)
 
HPO: HP:0100822

Definition

A Rectocele results from a tear in the rectovaginal septum (which is normally a tough, fibrous, sheet-like divider between the rectum and vagina). Rectal tissue bulges through this tear and into the vagina as a hernia. There are two main causes of this tear [from HPO]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVRectocele

Professional guidelines

PubMed

Management of female pelvic organ prolapse-Summary of the 2021 HAS guidelines.
Pizzoferrato AC, Thuillier C, Vénara A, Bornsztein N, Bouquet S, Cayrac M, Cornillet-Bernard M, Cotelle O, Cour F, Cretinon S, De Reilhac P, Loriau J, Pellet F, Perrouin-Verbe MA, Pourcelot AG, Revel-Delhom C, Steenstrup B, Vogel T, Le Normand L, Fritel X
J Gynecol Obstet Hum Reprod 2023 Mar;52(3):102535. Epub 2023 Jan 16 doi: 10.1016/j.jogoh.2023.102535. PMID: 36657614
Rectocele: Incidental or important? Observe or operate? Contemporary diagnosis and management in the multidisciplinary era.
Bharucha AE, Knowles CH
Neurogastroenterol Motil 2022 Nov;34(11):e14453. Epub 2022 Sep 14 doi: 10.1111/nmo.14453. PMID: 36102693Free PMC Article
Management of obstructed defecation.
Podzemny V, Pescatori LC, Pescatori M
World J Gastroenterol 2015 Jan 28;21(4):1053-60. doi: 10.3748/wjg.v21.i4.1053. PMID: 25632177Free PMC Article

Recent clinical studies

Etiology

Maternal and neonatal consequences of cystocele and rectocele in the delivery process.
Başkiran Y, Uçkan K, Çeleğen İ, Tanoğlu FB
Medicine (Baltimore) 2023 Dec 22;102(51):e36720. doi: 10.1097/MD.0000000000036720. PMID: 38134086Free PMC Article
Management of female pelvic organ prolapse-Summary of the 2021 HAS guidelines.
Pizzoferrato AC, Thuillier C, Vénara A, Bornsztein N, Bouquet S, Cayrac M, Cornillet-Bernard M, Cotelle O, Cour F, Cretinon S, De Reilhac P, Loriau J, Pellet F, Perrouin-Verbe MA, Pourcelot AG, Revel-Delhom C, Steenstrup B, Vogel T, Le Normand L, Fritel X
J Gynecol Obstet Hum Reprod 2023 Mar;52(3):102535. Epub 2023 Jan 16 doi: 10.1016/j.jogoh.2023.102535. PMID: 36657614
Posterior Vaginal Wall Prolapse: Suture-Based Repair.
Guzman-Negron JM, Fascelli M, Vasavada SP
Urol Clin North Am 2019 Feb;46(1):79-85. doi: 10.1016/j.ucl.2018.08.007. PMID: 30466705
Transperineal rectocele repair: a systematic review.
Zimmermann EF, Hayes RS, Daniels IR, Smart NJ, Warwick AM
ANZ J Surg 2017 Oct;87(10):773-779. Epub 2017 Sep 4 doi: 10.1111/ans.14068. PMID: 28871666
Management of obstructed defecation.
Podzemny V, Pescatori LC, Pescatori M
World J Gastroenterol 2015 Jan 28;21(4):1053-60. doi: 10.3748/wjg.v21.i4.1053. PMID: 25632177Free PMC Article

Diagnosis

Management of female pelvic organ prolapse-Summary of the 2021 HAS guidelines.
Pizzoferrato AC, Thuillier C, Vénara A, Bornsztein N, Bouquet S, Cayrac M, Cornillet-Bernard M, Cotelle O, Cour F, Cretinon S, De Reilhac P, Loriau J, Pellet F, Perrouin-Verbe MA, Pourcelot AG, Revel-Delhom C, Steenstrup B, Vogel T, Le Normand L, Fritel X
J Gynecol Obstet Hum Reprod 2023 Mar;52(3):102535. Epub 2023 Jan 16 doi: 10.1016/j.jogoh.2023.102535. PMID: 36657614
Dyssynergic Defecation and Other Evacuation Disorders.
Sharma A, Herekar A, Yan Y, Karunaratne T, Rao SSC
Gastroenterol Clin North Am 2022 Mar;51(1):55-69. Epub 2022 Jan 7 doi: 10.1016/j.gtc.2021.10.004. PMID: 35135665
Anorectal Disorders: An Update.
Rao SSC, Tetangco EP
J Clin Gastroenterol 2020 Aug;54(7):606-613. doi: 10.1097/MCG.0000000000001348. PMID: 32692116
Transperineal rectocele repair: a systematic review.
Zimmermann EF, Hayes RS, Daniels IR, Smart NJ, Warwick AM
ANZ J Surg 2017 Oct;87(10):773-779. Epub 2017 Sep 4 doi: 10.1111/ans.14068. PMID: 28871666
Management of obstructed defecation.
Podzemny V, Pescatori LC, Pescatori M
World J Gastroenterol 2015 Jan 28;21(4):1053-60. doi: 10.3748/wjg.v21.i4.1053. PMID: 25632177Free PMC Article

Therapy

Transperineal rectocele repair: a systematic review.
Zimmermann EF, Hayes RS, Daniels IR, Smart NJ, Warwick AM
ANZ J Surg 2017 Oct;87(10):773-779. Epub 2017 Sep 4 doi: 10.1111/ans.14068. PMID: 28871666
Laparoscopy for pelvic floor disorders.
Van Geluwe B, Wolthuis A, D'Hoore A
Best Pract Res Clin Gastroenterol 2014 Feb;28(1):69-80. Epub 2013 Dec 4 doi: 10.1016/j.bpg.2013.11.009. PMID: 24485256
Constipation and pelvic outlet obstruction.
Hedrick TL, Friel CM
Gastroenterol Clin North Am 2013 Dec;42(4):863-76. Epub 2013 Nov 6 doi: 10.1016/j.gtc.2013.09.004. PMID: 24280404
Surgical management of pelvic organ prolapse in women.
Maher C, Feiner B, Baessler K, Schmid C
Cochrane Database Syst Rev 2013 Apr 30;(4):CD004014. doi: 10.1002/14651858.CD004014.pub5. PMID: 23633316
The diaphragm.
Heaton CJ, Smith MA
Am Fam Physician 1989 May;39(5):231-6. PMID: 2718900

Prognosis

Rectocele: Correlation Between Defecography and Physical Examination.
Crowder CA, Sayegh N, Guaderrama NM, Jeney SES, Buono K, Yao J, Whitcomb EL
Urogynecology (Phila) 2023 Jul 1;29(7):617-624. Epub 2023 Jan 23 doi: 10.1097/SPV.0000000000001330. PMID: 36701286
Three years prospective clinical and radiologic follow-up of laparoscopic sacrocolpoperineopexy.
Bellido Luque J, Limón Padilla J, García Moreno J, Pascual Salvador E, Gomez Menchero J, Suarez Grau JM, Guadalajara Jurado J
Surg Endosc 2021 Nov;35(11):5980-5990. Epub 2020 Oct 13 doi: 10.1007/s00464-020-08083-5. PMID: 33051764
Transperineal rectocele repair: a systematic review.
Zimmermann EF, Hayes RS, Daniels IR, Smart NJ, Warwick AM
ANZ J Surg 2017 Oct;87(10):773-779. Epub 2017 Sep 4 doi: 10.1111/ans.14068. PMID: 28871666
Management of obstructed defecation.
Podzemny V, Pescatori LC, Pescatori M
World J Gastroenterol 2015 Jan 28;21(4):1053-60. doi: 10.3748/wjg.v21.i4.1053. PMID: 25632177Free PMC Article
Surgery for obstructed defecation syndrome - is there an ideal technique.
Riss S, Stift A
World J Gastroenterol 2015 Jan 7;21(1):1-5. doi: 10.3748/wjg.v21.i1.1. PMID: 25574075Free PMC Article

Clinical prediction guides

Management of female pelvic organ prolapse-Summary of the 2021 HAS guidelines.
Pizzoferrato AC, Thuillier C, Vénara A, Bornsztein N, Bouquet S, Cayrac M, Cornillet-Bernard M, Cotelle O, Cour F, Cretinon S, De Reilhac P, Loriau J, Pellet F, Perrouin-Verbe MA, Pourcelot AG, Revel-Delhom C, Steenstrup B, Vogel T, Le Normand L, Fritel X
J Gynecol Obstet Hum Reprod 2023 Mar;52(3):102535. Epub 2023 Jan 16 doi: 10.1016/j.jogoh.2023.102535. PMID: 36657614
Surgical anatomy of the mid-vagina.
Haylen BT, Vu D, Wong A, Livingstone S
Neurourol Urodyn 2022 Aug;41(6):1293-1304. Epub 2022 Jun 22 doi: 10.1002/nau.24994. PMID: 35731184Free PMC Article
Transperineal rectocele repair: a systematic review.
Zimmermann EF, Hayes RS, Daniels IR, Smart NJ, Warwick AM
ANZ J Surg 2017 Oct;87(10):773-779. Epub 2017 Sep 4 doi: 10.1111/ans.14068. PMID: 28871666
Management of obstructed defecation.
Podzemny V, Pescatori LC, Pescatori M
World J Gastroenterol 2015 Jan 28;21(4):1053-60. doi: 10.3748/wjg.v21.i4.1053. PMID: 25632177Free PMC Article
Prevalence of symptomatic pelvic floor disorders in US women.
Nygaard I, Barber MD, Burgio KL, Kenton K, Meikle S, Schaffer J, Spino C, Whitehead WE, Wu J, Brody DJ; Pelvic Floor Disorders Network
JAMA 2008 Sep 17;300(11):1311-6. doi: 10.1001/jama.300.11.1311. PMID: 18799443Free PMC Article

Recent systematic reviews

Magnetic resonance defecography versus clinical examination and fluoroscopy: a systematic review and meta-analysis.
Ramage L, Simillis C, Yen C, Lutterodt C, Qiu S, Tan E, Kontovounisios C, Tekkis P
Tech Coloproctol 2017 Dec;21(12):915-927. Epub 2017 Nov 1 doi: 10.1007/s10151-017-1704-y. PMID: 29094218
Surgery for constipation: systematic review and practice recommendations: Results IV: Recto-vaginal reinforcement procedures.
Grossi U, Horrocks EJ, Mason J, Knowles CH, Williams AB; NIHR CapaCiTY working group; Pelvic floor Society
Colorectal Dis 2017 Sep;19 Suppl 3:73-91. doi: 10.1111/codi.13781. PMID: 28960924
Transperineal rectocele repair: a systematic review.
Zimmermann EF, Hayes RS, Daniels IR, Smart NJ, Warwick AM
ANZ J Surg 2017 Oct;87(10):773-779. Epub 2017 Sep 4 doi: 10.1111/ans.14068. PMID: 28871666
Surgical management of pelvic organ prolapse in women.
Maher C, Feiner B, Baessler K, Schmid C
Cochrane Database Syst Rev 2013 Apr 30;(4):CD004014. doi: 10.1002/14651858.CD004014.pub5. PMID: 23633316
Surgical management of pelvic organ prolapse in women.
Maher C, Baessler K, Glazener CM, Adams EJ, Hagen S
Cochrane Database Syst Rev 2004 Oct 18;(4):CD004014. doi: 10.1002/14651858.CD004014.pub2. PMID: 15495076

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