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Rectocele question?

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Posted 9/21/2011 2:17 AM (GMT 0)
Hi all,
I had a defecography today. It went OK, aside from what the radiologist said looked like a rectocele. The weird thing was, the rectocele wasn't protruding forward like I have read about most rectoceles doing, instead, it was going towards my tailbone. It didn't seem big...and the radiologist said I had a "good empty" (except for that little pocket which didn't empty.) She said "this is not what is causing your constipation, but it was probably caused by your constipation. She said she doesn't think it will change anything (I have a total colectomy scheduled for November)...but of course she can't give an official opinion, I have to wait for the doctor. torture!

Anyways I was wondering if anyone has ever had, or heard of, a rectocele going in a different direction? I'm guessing it would be called a posterior rectocele?

Thanks everyone.
Posted 9/21/2011 3:19 AM (GMT 0)
Alibee,

Yes you are correct. That is a posterior rectocele instead of the usual anterior rectocele that protrudes into the vagina. Yours is like a pocket in the back of the rectum instead of in the front. Be sure you find out that your anorectal angle widens for defecation and angles for continence. The posterior rectocele can be a sign of anismus IF the rest of the rectum does not empty and IF the anorectal angle remains at 90 degrees during the rest, squeeze, and push phase of the test. This does NOT sound like your case, but do check that this angle opens as it should. You likely just have the posterior rectocele on its own.

Good luck. Rosemary
Posted 9/21/2011 7:24 AM (GMT 0)
i had a posterior rectocele back then before the STARR procedure. it was a small 1.5 cm rectocele. i'm not sure if the STARR fixed it. in the next defecographies i did after the STARR (and i did 3) they never mentioned it again, but that could be b/c not all drs consider it to be a problem or they just don't notice this at all..? i don't know. maybe as Rosemary sais, the anismus causes it (?) where did you read or hear about this, Rosemary? just curius.

anyway, i'm glad it went ok and the emptying was good. keep us posted.

Posted 9/22/2011 1:06 AM (GMT 0)
Hi Hodaya,

The anismus keeps the rectum angled at 90 degrees. As a consequence the puborectalis muscle which encircles the anorectal area does not relax to let the rectum straighten for defecation. Therefore there is a slight bulge in the back of the rectum because the puborectalis muscle is around it so tight. Rosemary
Posted 9/22/2011 10:30 AM (GMT 0)
i see, i never thought about this. but this maybe means that this posterior rectocele is not really a rectocele, but just the tightening of the pubo that makes it look like a rectocele. you know, being a dr is the most interesting thing i wish i could do. but now.... it's a bit too late for me now.
Posted 9/22/2011 4:35 PM (GMT 0)
Thanks gals,
I'll have to keep myself from over-analyzing anything until I hear more, but thankfully I was able to empty everything out of the rectum except for the little bit left in the rectocele, so the radiologist said that there wasn't anything obstructing my being able to empty, but it was likely caused by being constipated for my whole life.

Hodaya - it's not too late to do anything you want! Even if you weren't going to become a doctor you can always do something medical related. I think you would be so great at it. I read your other post about optics and dentistry - both of those are great ideas too!
Posted 9/22/2011 5:14 PM (GMT 0)
thanks so much Ali! and yeah, i'll be thankful to make it through one of those. i wrote to you on the colon inertia thread as well. i think you have good chances with the surgery! very excited for you!!
Posted 9/24/2011 5:25 PM (GMT 0)
Hodaya,
Yes, the posterior rectocele is likely just the tightening of the puborectalis muscle. IF this is her case, that is what I meant.

I too wish I had gone into medicine. For me, it would have helped me completely avoid the road I went down as I would have been on the "inside" track so to speak. I would have learned things that I could have applied to myself and my own well being. Teaching reading I helped the kids which I'm glad I did, but there was no new learning for me. BUT, in general, I know what you mean, the human body is very interesting, sort of like mechanics.

Rosemary
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