Presentation
G2P2 all normal vaginal deliveries, complaining of recurrent rectocele. History of rectocele repair with mesh & perineorrhaphy
Patient Data
3D transperineal ultrasound images of the pelvic floor show dislodgement of mesh between the vagina and the rectum, forming a bulge in the posterior vaginal wall without erosion or direct communication with the vaginal cavity. Mesh displacement to the internal anal sphincter is seen, with small areas of erosion of the anal mucosa.
Case Discussion
On clinical examination, a firm swelling was palpable on the posterior vaginal wall, showing no change in size on straining. This finding differentiated the swelling from recurrence of the rectocele.
The patient was referred to the colorectal surgery team for assessment, as any incorrect surgical dissection of the mesh risked leading to a rectovaginal fistula.
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