Which surgical approach provides pelvic support for rectocele?

• A. Hysterectomy
• B. Uterosacral or sacrospinous ligament fixation
• C. Oophorectomy
• D. Colporrhaphy

Answer: (B)

Restoring pelvic floor support for a rectocele relies on reattaching the vaginal apex to sturdy pelvic ligaments to lift and stabilize the posterior compartment. Uterosacral or sacrospinous ligament fixation accomplishes this by suspending the vaginal apex to the uterosacral or sacrospinous ligaments, providing durable support for the rectovaginal area and reducing prolapse recurrence, especially after procedures that have weakened pelvic support.

Colporrhaphy, while it reinforces the rectovaginal fascia to lessen the bulge, mainly offers a local repair rather than restoring the overall apical pelvic support. Hysterectomy or oophorectomy remove organs and don’t by themselves reestablish the pelvic suspension needed to correct rectocele.