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Cited by 26Pelvic floor disorders treatmentsGynecological conditions and treatmentsHernia repair and management

Consistently inconsistent, the posterior vaginal wall

Hale, Douglass S., Fenner, Dee·2016·American Journal of Obstetrics and Gynecology
DOI 10.1016/j.ajog.2015.09.001
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Abstract

Posterior vaginal wall prolapse is one of the most common prolapses encountered by gynecological surgeons. What appears to be a straightforward condition to diagnose and treat surgically for physicians has proven to be frustratingly unpredictable with regard to symptom relief for patients. Functional disorders such as dyssynergic defecation and constipation are often attributed to posterior vaginal wall prolapse. Little scientific evidence supports this assumption, emphasizing that structure and function are not synonymous when treating posterior vaginal wall prolapse. Rectoceles, enteroceles, sigmoidoceles, peritoneoceles, rectal and intraanal intussusception, rectal prolapse, and descending perineal syndrome are all conditions that have an impact on the posterior vaginal wall. All too often these different anatomic conditions are treated with the same surgical approach, addressing a posterior vaginal wall bulge with a traditional posterior colporrhaphy. Studies that examine the correlation between stage of posterior wall prolapse and patient symptoms have failed to reliably do so. Surgical outcomes measured by prolapse staging appear successful, yet patient expectations are often not met. As increasing attention is being placed on patient satisfaction outcomes concerning surgical treatments, this fact will need to be addressed. Surgeons will have to clearly communicate what can and what cannot be expected with surgical repair of posterior vaginal wall prolapse.

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  • The mismatch between expectations and goals may be influenced by inadequate counselling, poor 'customer' care, consideration of the impact of prolapse on body image, sexual function, and perhaps other indirect effects; those on a woman's anxiety, depression, and cognitive state.

    “This mismatch, and that between expectations and goals, may be influenced by inadequate counselling, poor ‘customer’ care, consideration of the impact of prolapse on body image, sexual function, and perhaps other indirect effects; those on a woman's anxiety, depression, and cognitive state [25, 26, 27, 28, 29].”

    From How Can We Improve the Assessment and Indifferent Outcomes From Pelvic Organ Prolapse Management From Conservative and Surgical Therapies? ICI‐RS 2025 (2026) · cites this paper as [28]

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Authors
Hale, D. S., & Fenner, D.
Affiliations
  • Indiana University Health (US)
  • University of Michigan (US)
Corresponding author
Hale, Douglass S.
ORCID
Fenner, Dee
Venue
American Journal of Obstetrics and Gynecology
Publisher
Elsevier BV
Published
2016-03
Volume
214
Issue
3
Pages
314-320
ISSN
0002-9378 (ISSN-L)
DOI
10.1016/j.ajog.2015.09.001
OpenAlex
W1539317765
Cited by
26
References
54
Citations by year
2026: 1 · 2025: 4 · 2024: 1 · 2021: 3 · 2020: 1 · 2019: 4 · 2018: 4 · 2017: 2 · 2016: 5 · 2015: 1
FWCI
0.62
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • American Journal of Obstetrics and Gynecology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Rheumatology › Pelvic floor disorders treatments
  • Health Sciences › Medicine › Obstetrics and Gynecology › Gynecological conditions and treatments
  • Health Sciences › Medicine › Surgery › Hernia repair and management
Keywords
posterior vaginal wall prolapse, pelvic organ prolapse, dyssynergic defecation, constipation, rectocele, enterocele, sigmoidocele, rectal intussusception, rectal prolapse, posterior colporrhaphy, prolapse staging, patient satisfaction, surgical outcomes
MeSH terms
Constipation, Female, Humans, Vagina, Vaginal Diseases, Pelvic Organ Prolapse

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