The subject of this paper is limited to hernias involving the posterior vaginal wall, which we frequently encounter and recognize under the designation of rectocele, and to the much rarer hernia which is made up of the culdesac of Douglas, with its intestinal contents dissecting its way downward between the posterior vaginal wall and the rectum, known as vaginal enterocele or posterior vaginal hernia.
The common condition of rectocele is the result of impairment of the function of the pelvic floor (the inability to properly close the vaginal mouth), due to injury in childbirth, thus allowing the vaginal wall to roll downward and outward with the attached rectum. This anatomic change in the relation of the parts alters the normal mechanism of defecation, the direction of the fecal current being changed so that the anterior rectal wall and the posterior vaginal wall receive the brunt of the strain and, consequently,
WARD GG. TECHNIC OF REPAIR OF ENTEROCELE (POSTERIOR VAGINAL HERNIA) AND RECTOCELE: AS AN ENTITY, AND WHEN ASSOCIATED WITH PROLAPSE OF THE UTERUS. JAMA. 1922;79(9):709–713. doi:10.1001/jama.1922.02640090017005
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