Examination for prolapse?

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I've been suffering with what I think is a rectocele for 5 years. I have symptoms (a bulge and problems opening bowels as well

As piles).

I finally got to see the local colorectal team today who reluctantly said they will book a proctogram.

My question is: why did the doctor just examine my back passage and not look at the state of my vagina?

Am I missing something???

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5 Replies

  • Posted

    Because he's a colorectal surgeon. my gynaecologist only looked at my front bit, although I have piles and fissure, said it wasn't his field.

    Sometimes I think they do repair through back passage, you need to see a urogynaecologist.

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  • Posted

    Hi Nm! Rectoceles have a different approach if they are fixed by a colorectal or a by a gyn. I have a rectocele also, it has appeared since my anterior repair. I went to a colorectal and he said he would not operate. They only operate them when they are severe. In a post op check with my gyn he told me that he could fix my rectocele from the vagina, he defends that this is the best way to do it.

    You only have to search YouTube videos of rectocele surgeries and will find the two approaches. You will come to the conclusion that the gyn approach is better and easier. I asked about this to Matron and she said that in UK rectoceles are solved by gynecologist (if I remember well). In Spain both gyns and colorectal surgeons do this op. I personally prefer the gym approach because of the risks.

    Before making up yourself on the surgery I recommend you to visit a PF specialist gyn.

    Hope this makes you clear, hugs!!!!

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  • Posted

    Hi. When I went to see gp about my prolapse she referred me to a gynaecologist. He examined my front and back passages confirmed both has prolapsed. So he referred me to a colorectal surgeon at a different hospital. So I've been back and forth to both. I don't recall the colorectal dr examining my vagina. Not sure if this was coz gyny had already done this or just not his role. I've since had total hysterectomy, A&P repair and tvt ( bladder sling). I'm 10 wks post op My bowels are loads better so far but once I've recovered I have to back to see colorectal dr again to see if I need to still have survey which I'm hoping I don't.

    Maybe when you go back to see them after the protogram you could ask about this.

    Good luck. Keep us informed. ??

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  • Posted

    I went to a colorectal surgeon first and he only did a rectal exam.  Fwiw, the rectocele is a tear in the fascia between the rectum and vagina and he can absolutely feel that fascia and any tears/holes in it even without examining your vagina.  TBH, my GP did both and she seemed to have a much easier time feeling it with a rectal exam.  My urogyn, on the other hand, only ever did vaginal exams.

    Don't worry, nothing is wrong.

    If you are in the UK I think it is normal to have a urogyn do the repair op.  In the US I have heard of both but I've heard urogyn more often.

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  • Posted

    When Matron was on here she ALWAYS said to let only a Urogynaecologist do anterior & posterior repairs. They have had 3yrs extra training to learn these procedures. I asked her very recently about my Gastroenterologist saying for me to see Colorectal Specialist within his practice re. my posterior prolapse. Matron said go back to my Urogynae who did my anterior repair Oct. 2015. Not just a Gyneacologist but a UROGYNAECOLOGIST.

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