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  • Q&A with Australian Health Practitioners

    Is my sex life going to be difficult after having rectocele repair?

    Related Topics
    Sexual Health Women's Health
    I am 64 years old and have been recommended to have rectocele surgery by my gyno. I am very anxious about resuming sexual intercourse after op after reading all the negative comments on the net.

    It seems to take so long to get back to normal and I am worried that my vagina will be adversely affected by the surgery. I would love to read any positive feedback on this operation to assist with my anxiety.

    I am also wondering if I will every be able to return to the gym again.
    • 2 answers
    • Dr David Moore
    • Dr Angamuthu Arun
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    Dr David Moore

    Gynaecologist, Gynaecologist - Infertility (IVF) Specialist, Obstetrician

    David received a solid foundation to training in tertiary obstetric units and has developed skills in the management of complex and high-risk pregnancies and deliveries. … View Profile

    Hi there!

    In general, the risk of pain with sexual intercourse after a rectocele repair depends on:

    1. presence of pre-existing pain with sex
    2. type of procedure (native tissue vs. mesh)
    3. 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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    Dr Angamuthu Arun

    Gynaecologist

    Dr Arun offers specialised service in the following areas: Holistic approach in the management of Urinary Incontinence including Urodynamics for women Botox injections to bladder … View Profile

    I agree with above comments.

    Barring mesh repair, there is no evidence to suggest that sex life worsens following native tissue repair (Posterior repair).

    Gradual return to sex life is recommended. I see patients at 6 weeks and after checking the repair site, they can resume sexual activity gradually.

    Lubricants, a glass of Red wine may calm the patient's nerves. The more the patients relax, less likely to be painful.

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