Posterior compartment prolapse: a urogynecology perspective.

Posterior compartment prolapse is often caused by a defect in the rectovaginal septum, also known as Denonvillier's fascia. Patients with symptomatic posterior compartment prolapse can present with bulge symptoms as well as defecatory dysfunction, including constipation, tenesmus, splinting, and fecal incontinence. The diagnosis can successfully be made on clinical examination. Treatment of posterior prolapse includes pessaries and surgery. Both traditional colporrhaphy and site-specific defect repair have excellent success rates. Complications from surgery can include sexual dysfunction, de novo dyspareunia, and defecatory dysfunction. Compared with native tissue repair, biological and synthetic grafting has not improved overall anatomic and subjective outcomes.