Uzm. Dr. Ertan Özen
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- 36+years exp.
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Gynaecological Surgery
Posterior colporrhaphy
What posterior colporrhaphy (rectocele repair) is, how the back wall of the vagina is tightened to correct a bulge into it, what the evidence says about symptom relief and recurrence, who suits surgery rather than pelvic floor therapy or a pessary, approximate costs in Turkey against the UK, US and Germany, recovery milestones, risks and how to check a gynaecology team.
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Prof. Dr. Zehra Neşe Kavak
GynaecologyVerified
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What is posterior colporrhaphy, and which problem does it treat?
Posterior colporrhaphy is a vaginal operation that repairs a weakness in the back wall of the vagina. When the supporting layer of tissue between the vagina and the rectum thins or tears, the rectum can bulge forward into the vagina. This bulge is called a rectocele, and it is a form of pelvic organ prolapse. The operation, sometimes called a posterior repair or rectocele repair, tightens that tissue with stitches and removes surplus vaginal skin, so the wall is supported again. Gynaecology and urogynaecology departments in Turkey perform it routinely, often together with other prolapse repairs.
This guide explains how the operation works, what symptoms it can and cannot fix, what the evidence says, what it costs compared with the UK, US and Germany, and how recovery goes. It is general information, not personal medical advice. For related services see our gynaecology treatments in Turkey.
Which symptoms point to a rectocele?
Many women have a mild rectocele with no symptoms at all. When symptoms occur, typical ones are a feeling of a lump or dragging in the vagina, a need to press on the vaginal wall or the area behind it to empty the bowels, a sense of incomplete emptying, constipation and sometimes discomfort during sex. Rectoceles are linked to childbirth, repeated straining, ageing, menopause and previous pelvic surgery. Your gynaecologist will examine you, may ask about bowel and bladder habits and, if the symptoms are mainly bowel-related, may arrange imaging or a bowel assessment, because constipation can have other causes that surgery will not correct.
How is posterior colporrhaphy performed, step by step?
The operation is done under spinal or general anaesthesia and normally takes 30 to 60 minutes. The surgeon makes a cut in the back wall of the vagina, separates the vaginal skin from the underlying tissue and then stitches the fibrous layer over the bulging rectum to rebuild the support. If needed, the muscles around the lower vagina may be brought together. Excess vaginal skin is trimmed and the wall is closed with dissolving stitches. A vaginal pack or catheter may be left for several hours or a day. There is no cut on the abdomen, and the sutures are inside the vagina, so no visible scar is left.
Does posterior colporrhaphy work, and what does the evidence say?
For a bulge or lump feeling, the operation is effective in most women, and studies report good relief of vaginal bulge symptoms. The evidence for bowel symptoms is more mixed. Difficulty emptying improves in many women but not all, and constipation without a bulge is not a reliable reason to operate. Prolapse can come back, because the tissue that was weak before is the tissue used for the repair. Synthetic mesh placed through the vagina to reinforce the repair is not recommended in the UK for routine prolapse repair, and NICE guidance reflects this concern; a reputable surgeon will offer a repair using your own tissue. Any promise of permanent cure should be treated with caution.
Posterior colporrhaphy cost in Turkey compared with the UK, US and Germany
The figures are approximate ranges for the operation done on its own in a private hospital; they are not quotes. Each hospital confirms its own price after reviewing your history.
| Country | Approximate cost range |
|---|---|
| Turkey | €1,800 – €5,000 |
| United Kingdom | €5,000 – €10,500 |
| United States | €8,000 – €24,000 |
| Germany | €4,000 – €9,000 |
What changes the price: whether the repair is combined with a front-wall repair, a hysterectomy or a perineal repair, spinal or general anaesthesia, the number of nights in hospital and the surgeon's team. A package should list pre-operative tests, surgeon and anaesthetist, hospital stay, medication, follow-up and transfers. Ask for it in writing, and confirm what is charged if you need to stay longer.
Surgery, pessary or pelvic floor exercises: what are the alternatives?
Surgery is not the first step for everyone, and not every rectocele needs treating. Pelvic floor muscle training under a physiotherapist, dietary and stool-softening measures for constipation and a vaginal pessary (a removable support ring) are often tried first. Surgery is considered if symptoms stay bothersome. The type of repair also depends on which part of the vagina has dropped.
| Option | Best suited to | Typical limits |
|---|---|---|
| Pelvic floor training and bowel care | Mild rectocele; first step for most women | Does not reverse a large bulge |
| Vaginal pessary | Women who prefer to avoid or delay surgery, or are not fit for it | Needs regular changes and can cause discharge |
| Posterior colporrhaphy | Bothersome bulge on the back wall that has not responded | Recurrence is possible; may not cure constipation |
If the uterus has also dropped or you have other gynaecological problems, the surgeon may suggest a combined procedure; see hysterectomy and our overview of gynaecological surgery.
Who is a candidate for posterior colporrhaphy, and who should wait?
Surgery suits women with a symptomatic rectocele who have tried conservative care, or who find a pessary unsuitable. It is usually put off if you are planning more pregnancies, because childbirth can undo the repair; the surgeon should discuss vaginal delivery and caesarean options with you. Surgery should also wait while there is an untreated infection, active smoking affecting healing, severe constipation that is not controlled or medical conditions that make anaesthesia risky. Vaginal oestrogen cream before surgery is often advised after menopause to help the tissue heal.
Posterior colporrhaphy recovery and how long to stay in Turkey
Most women stay in hospital one to two nights. Expect soreness, light bleeding or discharge for a few weeks and some difficulty passing urine on the first day. The key to a good recovery is avoiding straining: take stool softeners, drink water and eat fibre so that you do not push hard on the toilet. Avoid heavy lifting for about six weeks. Walking is encouraged from the first day, and most women return to desk work after two to three weeks. Sex and tampons are normally postponed for six to eight weeks, until the surgeon confirms healing. Plan seven to ten days in Turkey so that a check-up can take place before you fly; short flights are usually fine after that, with regular walking and fluids.
What are the risks of posterior colporrhaphy?
Common short-term effects are pain, bruising, swelling and spotting. Less common problems include infection, bleeding or a collection of blood (haematoma), difficulty passing urine for a short time, constipation, pain during intercourse because the vagina is tightened or scarred, and a return of the prolapse. Rare complications include injury to the rectum or a fistula between the vagina and bowel. The Royal College of Obstetricians and Gynaecologists and the NHS describe prolapse surgery risks in their patient information, and it is worth reading them before consenting. Ask how the surgeon reduces the chance of painful intercourse, which is the main complaint after this operation.
How do I choose a gynaecologist or urogynaecologist, and what should I ask?
Look for a specialist in gynaecology or urogynaecology registered in Turkey who performs prolapse repairs regularly, in a licensed hospital with an anaesthetist, and who examines you or reviews your history before quoting. Red flags are a quote without an examination, a promise of "tightening" for cosmetic reasons dressed up as medical repair, no clear plan for aftercare and pressure to book quickly. Read how our process works and send your history through our free quote page. Questions to ask:
- Is a posterior repair enough, or do I need other parts of the prolapse treated?
- Will you use only my own tissue, or any mesh or graft?
- What is the chance that the bulge comes back, and what would I do then?
- How do you reduce the risk of painful sex?
- What is included in the price, and who reviews me after I return home?
Hospitals with Gynaecology in Turkey
Frequently asked questions
Posterior colporrhaphy is a vaginal operation that repairs a rectocele, a bulge of the rectum into the back wall of the vagina. The surgeon stitches the supporting tissue and trims surplus vaginal skin to rebuild the wall.
It relieves the feeling of a vaginal bulge in most women. Bowel symptoms such as difficult emptying improve less reliably, and the prolapse can return because your own tissue is used for the repair.
Approximate private-hospital ranges are €1,800 to €5,000 in Turkey against about €5,000 to €10,500 in the UK. The price depends on combined procedures, anaesthesia and nights in hospital, and the hospital confirms it in a written quote.
The operation usually takes 30 to 60 minutes under spinal or general anaesthesia. Most women stay one to two nights in hospital.
Expect to avoid heavy lifting and straining for about six weeks. Many women return to desk work after two to three weeks, and sex is usually postponed for six to eight weeks until the surgeon confirms healing.
You are anaesthetised during the operation. Afterwards there is soreness and spotting that is usually controlled with regular painkillers and eases over one to two weeks.
Yes, recurrence is possible, particularly with heavy lifting, chronic constipation, obesity or further childbirth. Keeping stools soft and avoiding straining lowers the chance.
Some women have pain during intercourse afterwards because the vagina is tightened or scarred, and this is the most common complaint. Ask your surgeon how they try to avoid it and wait until you are cleared before having sex.
Not always. A mild rectocele without symptoms needs no treatment, and pelvic floor training, bowel care or a pessary are tried first. Surgery is for a bothersome bulge that has not responded.
Plan seven to ten days: one to two nights in hospital and a follow-up check before you fly home, so that the surgeon can confirm your wound and bladder function are settling.
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