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I focus on getting rid of the posterior bulges. In this case a large rectocele and an enterocoele sneaking in and can be easily missed. If you do not close up that sac you will increase your failure rate. You may cure a rectocele made of large bowel/rectum only to have another bulge grow and blow but but this time filled with small bowel. You need to close both sacs.
Here are the steps for my Posterior Compartment Repair using the Levatorplasty method that is integrated into the vaginoplasty tightening. I also include the short section on getting rid of an enterocoele and securing the closure of the potential space that an enterocoele can slide into. This also includes the Perineoplasty to eliminate the gaping vagina.
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