WHAT IS RECTOCELE? It is a condition seen in women, due to the expansion and ballooning of the part of the intestine close to the anus, where the feces fill the ballooned area and the patient evacuates the stool incompletely.
WHAT ARE THE SYMPTOMS AND PATIENT COMPLAINTS. ? Patients say that they have suffered from constipation for many years. In fact, the patients have even forgotten how to defecate normally because they have gotten used to it for many years, and they think that every person who says they are constipated is experiencing what they are experiencing. When asked about the patient's complaints due to the density of the outpatient clinic and the patient's hesitation, doctors find the answer of "constipation" sufficient and prescribe medication. Patients have used those medications and herbal teas many times for many years; They take the helpless prescription and leave. The hope that one day a doctor will diagnose the patients' complaints that they cannot fully describe is the reason for them to go to another hospital again. The key question is the answer to the question of how long and how the patient has been constipated. This question is a ray of hope for the patient's distress that he cannot define, but it is not enough to describe it. Doesn't defecating on a patient make you feel better? Patients with rectocele wait for the doctor to ask whether they can fully evacuate at once, whether they go to the toilet frequently intermittently, and whether they can only defecate a small amount at a time. They look at the doctor who asks these questions with joy and happiness, their eyes shine, and a ray of hope arises for the patient; He begins to tell the rest to his doctor with excitement and enthusiasm. The last question the doctor will ask is a question that the patient cannot be asked without asking, and which is unlikely to be diagnostic for the doctor. – Do you use your hand or finger to help pass the stool while defecating? – The answer that cannot be said unless asked, is ashamed, and that the moment you ask the question, the answer that will be given with its head down, embarrassed after moving its eyes over the secretary and nurse in the examination room, is "YES". Now the patient is relieved and the difficult part is over. Examination is insufficient for diagnosis. Diagnosis is not made by rectoscopy and colonoscopy. The most important diagnostic tool is starting to be abandoned. The method used is the "DEFECOGRAPHY" method, which is considered the old method because more modern devices have been developed. Boiled potato puree mixed with barium, which does not transmit X-rays, is sent to the patient's intestine, through the anus, through a thin cannula. The patient is told to defecate by taking simultaneous images, and during defecation, the movements of the intestine, its folds, angulations, ballooning areas, if any, intussusception, and prolapse of the intestine are seen under scopy. RECTOCELE - Ballooning occurs during defecation and straining in the last part of the intestine, shown in the circle in the figure, and the stool escapes out of its normal path. RECTOCele Figure is the normal DEFECOGRAPHY picture. Intestinal angulation during defecation, during straining and rest, the full and empty state of the intestine, and whether the intestine balloons to one side during defecation provides valuable information for diagnosis. Defecography is not requested by physicians due to the idea that it is an old method. However, there is no other method that can replace this examination. RECTOCELE The figure shows ballooned bowel. These patients cannot fully evacuate during defecation and become tired after straining for a long time. They leave the toilet with the feeling of insufficient or incomplete ejaculation, and after walking and waiting for a while, they enter the toilet with the desire to defecate again.
Read: 0
