Repair of rectocele (separate procedure)
CPT4 code
Name of the Procedure:
Repair of Rectocele (Rectocele Repair, Posterior Vaginal Wall Repair)
Summary
Rectocele repair is a surgical procedure to correct a rectocele, which is a condition where the rectum bulges into the vagina due to weakened tissues between these organs. The surgery aims to restore normal anatomy and relieve associated symptoms.
Purpose
Rectocele repair addresses the protrusion of the rectum into the vaginal wall, commonly caused by childbirth, aging, or chronic straining. The goal is to alleviate symptoms such as vaginal bulging, discomfort, constipation, and incomplete bowel movements, and to restore normal pelvic function.
Indications
- Vaginal bulging or pressure
- Discomfort during sexual intercourse
- Difficulty with bowel movements (constipation, straining)
- Recurrent urinary tract infections
- Visible or palpable protrusion into the vaginal canal
- Symptoms affecting quality of life
Preparation
- Fasting for 8-12 hours prior to surgery
- Discontinuation or adjustment of certain medications (e.g., blood thinners)
- Preoperative physical examination and medical history review
- Pelvic exam and possibly imaging tests (e.g., MRI, ultrasound)
- Bowel preparation (laxatives or enemas) as instructed by the surgeon
Procedure Description
- Anesthesia: General or regional anesthesia (spinal/epidural) is administered.
- Incision: A small incision is made in the vaginal wall.
- Dissection: The surgeon separates the rectum from the vaginal wall.
- Repair: The torn or weakened tissue is sutured together to reinforce the vaginal wall and push the rectum back into its normal position.
- Closure: The incision in the vaginal wall is closed with absorbable sutures.
- Postoperative Care: The patient is monitored for a short period before being moved to recovery.
Duration
Typically, the procedure takes about 1-2 hours.
Setting
The procedure is usually performed in a hospital or outpatient surgical center.
Personnel
- Surgeon (typically a gynecologist or colorectal surgeon)
- Anesthesiologist
- Nurses and surgical technicians
- Recovery room staff
Risks and Complications
- Common: Infection, bleeding, pain, recurrence of the rectocele
- Rare: Damage to surrounding organs (bladder, rectum), blood clots, anesthesia complications
- Management: Antibiotics for infection, pain management strategies, additional surgery if necessary
Benefits
- Alleviates symptoms associated with a rectocele
- Improves bowel function and sexual activity
- Enhanced quality of life Benefits are typically realized within a few weeks of the procedure.
Recovery
- Short hospital stay (often same day)
- Pain management with medications
- Avoid lifting heavy objects and straining for several weeks
- Restriction on sexual activity for 6 weeks
- Follow-up appointments to monitor healing
Alternatives
- Pelvic floor physical therapy: Non-surgical approach to strengthen pelvic muscles
- Pessary: A device inserted into the vagina to support vaginal wall
- Observation: Monitoring without intervention if symptoms are mild
Patient Experience
- During the procedure: Under general or regional anesthesia, no pain is felt
- Post-procedure: Some discomfort, manageably treated with pain medications
- Recovery: Gradual improvement with adherence to post-op instructions, mild to moderate pain or discomfort initially, resuming normal activities slowly
Pain management and ample rest are crucial for a comfortable recovery.