In general, the risk of pain with sexual intercourse after a rectocele repair depends on:
- presence of pre-existing pain with sex
- type of procedure (native tissue vs. mesh)
- addition of a levator ani plication (or levatoplasty) to the procedure
For this reason, it is best to discuss the exact planned procedure with your gynaecologist.
Many women who already experience discomfort during sex due to a rectocele will report improvement in this symptom after their procedure. For those who don't have difficulty, the risk of developing new difficulty is aroun 2-3%, up to 10% if levatoplasty is performed. Levatoplasty is thought by some to reduce the risk of rectocele recurrence but, in my opinion, should be avoided in women who are sexually active. Likewise, mesh repairs are associated with a risk of mesh erosion and pain with sex and, in general, should be avoided in most circumstances.
Most gynaecologists would perform a “native tissue” repair (aka posterior colporrhaphy) in the first instance, and you can be reassured that the vast majority of women are satisfied with the outcome of their surgery.
After your operation healing is complete, I would generally recommend a gradual
resumption of intercourse, with plenty of lubrication, to gradually build your confidence that sex will not be painful. Immediate return to the previous level of intercourse may cause discomfort, which runs the risk of establishing an association of sex with pain, which can set up a vicious cycle.
I hope that info helps. Best wishes for your operation.
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