Rectocele occurs when part of the wall of the rectum bulges into the vagina. Also called "posterior prolapse," it can be caused by multiple or difficult childbirths, chronic cough, chronic constipation, and weakened vaginal muscles. Rectocele is more common in postmenopausal women, and in women who are obese and/or smoke.

Symptoms of Rectocele

In some cases, when a rectocele is small, it is asymptomatic. In other cases, it causes a small bulge of vaginal tissue to protrude through the vaginal opening. Additional symptoms of rectocele include the following:

  • Difficulty having a bowel movement
  • Pain or pressure in the vagina or rectum
  • Painful intercourse

A woman who has a rectocele may experience other posterior prolapse conditions, such as cystocele or uterine prolapse.

Diagnosis of Rectocele

Rectocele is diagnosed through a pelvic examination of the vagina and rectum. Symptoms are reviewed, and an MRI scan or X-ray may be used to determine the size of the tissue bulge, and whether it has caused any internal blockages.

Treatment of Rectocele

Treatment for a rectocele depends on its size and severity. In some cases, especially in ones that are asymptomatic, monitoring is all that is necessary. Kegel exercises may be recommended to strengthen pelvic muscles. Other cases may require a pessary to support the vagina and the bulging tissue. In severe cases, colporrhaphy, a surgical procedure for correcting defects in the vaginal wall or rectum, may be necessary.

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