Information and Treatment for Rectocele
What Is a Rectocele?
A rectocele is formed when the front wall of the rectum bulges (herniates) into the back wall of the vagina. The tissue between the rectum and the vagina can thin and weaken over time, resulting in a rectocele.
What Causes a Rectocele?
A rectocele may occur on its own or as part of a generalized weakening of the pelvic floor muscles. Other pelvic organs such as the bladder (cystocele) and the small intestine (enterocele), can bulge into the vagina, leading to similar symptoms as a rectocele.
Advanced age, multiple vaginal deliveries, and birthing trauma during vaginal delivery contribute to weakening of the pelvic floor. Chronic constipation and excessive straining with bowel movements are thought to play a role in the formation of a rectocele.
What Are the Symptoms of a Rectocele?
When rectoceles are small, most women have no symptoms.
Symptoms of a rectocele may be categorized as either rectal or vaginal. Rectal symptoms may include difficult bowel movements and the need to press against the back wall of the vagina and/or space between the rectum and the vagina to pass stool. Vaginal symptoms include the sensation of a bulge or fullness in the vagina, tissue protruding from the vagina, discomfort during intercourse, and vaginal bleeding.
How Common Is a Rectocele?
A rectocele is found in about 40 percent of women during routine physical exams, according to the American Society of Colon and Rectal Surgeons. Often, the patient is experiencing no symptoms.
How Is a Rectocele Diagnosed?
A pelvic exam includes both a vaginal and rectal examination. A digital rectal exam will be performed to assess weakness in the wall of the rectum closest to the vagina. A special X-ray, called defecography, can also confirm a rectocele.
What Can I Do about a Rectocele?
It’s vital to have a good bowel routine to avoid constipation and straining with bowel movements. Follow a high-fiber diet and drink six to eight 10-ounce glasses of water daily so that your digestive system forms softer, bulkier stools that you can pass easily. That will reduce your risk for having a symptomatic rectocele.
What Treatment Is Available?
A rectocele only requires treatment if you are having significant symptoms that interfere with your quality of life.
There are both medical and surgical treatment options. Most symptoms of rectocele can be resolved with medical management, such as consuming more fiber and drinking more water to avoid constipation, and doing exercises to strengthen your pelvic floor.
Surgery is only for the most severe cases, when conservative measures have failed to relieve symptoms that interfere with your activities of daily living.
When Should I Make an Appointment with a Specialist?
If you are having significant symptoms related to a rectocele that interfere with your quality of life, you should consult a specialist. The Women’s Medicine Collaborative has specialists who can help.