Commonly seen forms of curable defecation dysfunction can be difficulty with elimination related to rectocele, incontinence of stool related to anal sphincter deficiency, and anal incontinence related to colonic hyperactivity. Rectocele is a term used to describe a bulge of the rectal wall into the posterior vagina. This is essentially a hernia, or weakening, of the connective tissue or fascia between the rectum and the vagina. The primary risk factors for this condition are vaginal birth, age, and chronic constipation. Symptoms of this condition might be difficulty completely emptying the rectum with bowel movements, and sensation of vaginal pressure and bulge. I perform rectocele repair using the latest available technology, minimizing recurrence risk while affording relief of symptoms and maintaining vaginal function.
Anal sphincteroplasty is a procedure designed to tighten the anal sphincter in some patients with incontinence of stool. If the anal sphincter was damaged (due to age or childbirth) and has been weakened, this procedure might prove beneficial in restoring continence of stool. This is an outpatient procedure.
Medication and dietary changes can assist with the last of these, anal incontinence related to colonic hyperactivity. If these conservative measures prove unsuccessful, Interstim sacral nerve stimulation may be considered. Short term testing of sacral nerve stimulation is performed with temporary lead placement in the office. If successful, permanent lead placement of a sacral nerve stimulator is performed in the Operating Room.