What is the difference between rectocele, periocele (I think it's called), and vaginal rejuvenation?

I had a rectocele snd something else done that my health insurance covered. It never took and I now have a spot that I have no feeling in im assuming is nerve damage. I sometimes have trouble with bm(s) and it looks like my insides are falling out. Also it only feels like the bottom part of the vagina was touched and he sutured my labia minora funny to make the opening look smaller. Can this be fixed?

Doctor Answers 3

Rectocele vs Perineocele. Very different than vaginal rejuvenaiton.

From your description, it sounds as though your prolapse repair did not hold or did not address the problem. A rectocele refers to the posterior (back) wall of the vagina that is damaged allowing the rectum to bulge into the vagina. This often occurs following vaginal delivery or chronic straining. As rectoceles progress they can cause difficulty with having bowel movements. A common mistake by surgeons is to simply tighten the vaginal wall but this can often result in difficulty with intercourse or recurrence of the rectocele.
A perineocele is very specific type of prolapse which has to do with the seperation of the pelvic floor muscles. A detailed exam by a urogynecologist can help determine the difference.
On the other hand, correctly repairing a rectocele does not necessarily make the vagina tighter only corrects the defect allowing you to improve bowel function. A vaginoplasty can be performed at the same time provided  the surgeon has experience in both correctly repairing the specific defect as well as cosmetic surgery.
Based on your description, it sounds like you had tightening of the opening which makes the vagina look tighter but doesn't seem to address the rectocele or problem that you are having with bowel movements. This can be corrected but would require a thorough exam to plan your surgery correctly.
Hope this helps.

Bay Area Urogynecologist
5.0 out of 5 stars 10 reviews

Rectocele vs Perineocele vs Vaginal Rejuvenation

A rectocele is a bulge of the posterior vaginal wall and the underlying anterior rectal wall into the lumen of the vaginal canal. It is the result of broken connective tissue beneath the skin - a type of hernia. A perineocele is a bulge of the perineum at the vaginal opening. It is the result of a break between the connective tissue that holds the posterior vaginal wall and the perineum together. Also a type of hernia. These conditions are fixed by excising a small amount of weakened, stretched tissue and repairing the areas with layers of sutures. Vaginal rejuvenation (aka vaginoplasty) involves suturing the Kegel muscles (levator muscles) together and tightening the posterior vaginal wall and perineum. The main difference is that the rectocele/perineocele repairs aren't really intended to tighten the vaginal canal - they fix bulges caused by hernias, nothing more, nothing less and a mild degree of perineal or vaginal tightening might happen, but not to the degree produced by vaginoplasty. Of course, both types of surgeries can be combined in expert hands.

If you have continuing problems, you need additional evaluation to see what's going on.


It sounds like you had a rectocele repair with a perineoplasty that did not heal well. In most cases this can be fixed and relieve the symptoms that you are having. I would seek out a consultation with a urogynecologist for options on fixing this. 

John Baten, MD
Jackson OB/GYN
5.0 out of 5 stars 1 review

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.