The posterior compartment of the vagina comprises the zone from the cervix until to the perineal body where different key structures, which contain connective tissue, can be deteriorated as a result of a trauma (e. g complicated vaginal birth), previous hysterectomy or an increased body mass index. These structures include the uterosacral and cardinal ligaments, the rectovaginal fascia (RVF) and the perineal body (PB), all of them playing also an important role in the pathophysiology of other vaginal wall disorders (anterior and/or median vaginal defects). However, the grade of connective tissue disruption seems not to be correlated with the severity of the dysfunction. A posterior vaginal defect exteriorizes itself in the form of a rectocele, enterocele or sigmoidocele and it generally requires surgical repair when symptomatic with impact on the patient’s daily activities. The role of this review is to make a review of the literature regarding the possible transvaginal approaches to the posterior compartment defects, and namely the posterior colporrhaphy and repair of the RVF with or without grafts, focusing on the technique, success and recurrence rates of the different methods as well as the reasons to choose between different therapeutic options.
Keywords: posterior compartment, rectocele, prolapse, rectovaginal fascia.
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