Presentation of

AHN1
Objectives:
Defination
Rectocele is an upward pouching of the
rectum that pushes the posterior wall of
the vagina forward
An enterocele is aprotrusion of the
intestinal wall into the vagina
Tear of musculature blew the vagina
Weakening of the support structures of
the uterus itself
The cervix drops and may protrude from
the vagina.
Rectovaginal septum
Damage of tissues or cells that present between
rectum and vagina is called rectovaginal septum
Factores that damage
rectovaginal septum
• During giving birth
• During long and difficult labor
• Advance age
• Straining topass bowl motion
Clinical Menifestation
• Pelvic pressure
• Fatigue
• Urinary incontinence
• Back pain
• Pelvic pain
• Rectal pressure
• Constipation
• Uncontrollable gas
• Fecal incontinence
• Ulcerations
• Bleeding
• Dyspareunia
 Medical management
• Physical Examination
• Kegel exercises
• Use Pessaries
• Follow up checkups
• Use Colpexin sphere
• Remove daily
• Cleaning these devices
 Surgical Management

Colporrhaphy Repair of a rectocele is called

a posterior colporrhaphy.
Perineorrhaphy Repair of perineal lacerations
is called a perineorrhaphy.
laparoscope is inserted through a small abdominal
incision.
Nursing management
• Preventive Measures
• Patient Education
• Relaxed pelvic muscles
• Kegel exercises
• Preoperative Nursing Care
• Purpose of surgery
• Rectocele repair
• Enema before surgery
• Lithotomy position for surgery
• Initiating Postoperative Nursing Care
• Preventing infection
• Perineal care
• Catheterized if Dysuria
• Bladder care
• Sitz bath
• Spcial care for superineal laceration
(through
• the rectal sphincter)
• Stool-softening agents are administered
• Soft diet
• Promoting Home and Community-Based Care
• Teaching Patients Self-Care
• Prevention of constipation
• recommended exercise
• avoiding lifting heavy objects
• Avoiding standing for prolonged periods.
• Report any pelvic pain
• Report unusual discharge
• Report vaginal bleeding.
• Continuing Care
• perineal exercises,
• improve muscle strengt tone
• follow-up visit