Giant Rectocele Mimicking Cystocele in an Elderly Woman with Long-Term Manual Vaginal Splinting After Home Deliveries: A Case Report
DOI:
https://doi.org/10.65495/eurjimr.2026.15Keywords:
Rectocele, Obstructed defecation, Posterior colporrhaphy, Pelvic floor disorders, Case reportAbstract
Background: Large rectoceles are a recognized cause of obstructed defecation in multiparous women, yet markedly enlarged lesions that clinically resemble anterior compartment prolapse are uncommon. Misinterpretation as cystocele may delay definitive diagnosis and management, particularly in patients with limited access to specialized care.
Case Presentation: A 71-year-old woman with a history of five unassisted home vaginal deliveries presented with a decade of obstructed defecation, incomplete evacuation, and chronic reliance on manual vaginal splinting. Initial gynecologic evaluation suggested cystocele; however, targeted pelvic examination and magnetic resonance imaging revealed an isolated grade III rectocele without accompanying cystocele or enterocele. She underwent native-tissue transvaginal rectocele repair with posterior colporrhaphy and perineoplasty. Recovery was uneventful, and at 6-month follow-up she remained fully asymptomatic, with complete resolution of splinting and no evidence of recurrence.
Conclusion: This case highlights that giant rectoceles may mimic anterior compartment prolapse and remain untreated for years when healthcare access is limited. Accurate compartment-specific assessment supported by imaging is crucial for avoiding diagnostic error. Native-tissue transvaginal posterior colporrhaphy with perineoplasty offers an effective, mesh-free solution with excellent functional outcomes even in severe, long-standing rectocele.
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Copyright (c) 2026 Mert Yiğit Akdoğan, Veysel Barış Turhan, Mahmut Arif Yüksek (Author)
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