A health condition in which the muscles in the pelvic area become weakened and often cause the rectum to sag against the vaginal wall is called rectocele. However, it is a type of pelvic organ prolapse. When the bulge is small, people usually do not experience symptoms. You may develop constipation if the prolapse is more significant. In most cases, rectocele is treated with nonsurgical procedures.
If this condition occurs when the tissue between the vagina and rectum weakens, it is called posterior vaginal wall prolapse. The bottom part of the colon (large bowel) is called the rectum. In normal circumstances, the muscles in the pelvic area hold the rectum and vagina in place. Furthermore, people with rectocele often develop uterine prolapse and a fallen bladder.
This disorder is not life-threatening, but it may reduce your quality of life.
Symptoms
Usually, people with this condition experience the following symptoms. For example:
- A bulge that you can feel in the back wall of the vagina
- A feeling like the rectum has not completely emptied
- Fecal incontinence (incontrollable poop leakage)
- Loss of muscle tone in the vagina
- Dyspareunia (painful sexual intercourse)
- Fullness or pressure in the rectum and vagina
- Fecal urgency (pooping several times per day)
However, this condition does not always cause symptoms. Do not hesitate to see a doctor if any of the previous symptoms occur.
Causes and Risk Factors
In general, a rectocele appears when the muscles in the pelvic area become weakened. Check below some factors that may elevate your risk of developing this disorder:
- Multiple pregnancies and births – The muscles in the pelvic floor may become weakened over time, especially if you have had more than 5 births.
- Vaginal delivery – Your risk of developing rectocele also increases with vaginal delivery, especially if the doctors use forceps or a vacuum.
- Aging – In general, the pelvic floor muscles tend to weaken with aging. However, the risk may also increase due to hormonal changes that occur in menopause.
- Obesity – Excessive body weight may also contribute to rectocele.
- Chronic constipation – People with this health problem constantly strain to poop, which puts pressure on the pelvic floor muscles.
- Chronic cough
- Bronchitis
- Repeated heavy lifting
This article does not contain a complete list of factors that could increase your risk of developing rectocele. For more details, discuss it with your doctor.
Complications
This disorder, as well as surgery to treat it, may cause some complications. Check below some of them:
- Allergic reactions to the anesthesia
- Infections
- Bleeding
- Surgery failure (in such cases, rectocele may return after surgery)
- Blood clots
- Damage to nearby structures, including blood vessels, the bladder, nerves, and other pelvic organs
- Urinary problems
- Sexual dysfunction
Consult with your healthcare professional about ways to reduce the risk or prevent previous complications.
How to Prevent Rectocele?
It is not always possible to prevent this condition. However, there are multiple exercises that may help strengthen the muscles in the pelvic area.
Diagnosis
Usually, if your doctor suspects rectocele, you may be referred to a gynecologist. Therefore, he/she will perform a pelvic examination to check for abnormalities linked to the disease. They may also perform a pelvic floor strength test during this examination. Gynecologists often ask some questions about the symptoms and medical history to get more clues about the condition.
Rarely, doctors may perform some tests to check if the small intestine is prolapsed or to identify changes in the rectum when you poop. These include transvaginal ultrasounds and a special X-ray or MRI (magnetic resonance imaging) known as a defecography.
Treatment
Doctors typically attempt to resolve this issue with nonsurgical procedures, especially in mild cases. However, if you develop a moderate to severe condition, you may need surgery to repair it. Check below some common treatments often recommended for people with rectocele:
Nonsurgical Options
These include:
- Pelvic floor exercises – These include Kegels that help strengthen the muscles in the pelvic area.
- Options to prevent constipation and straining – For example, doctors may recommend adding more fiber to your diet and drinking plenty of water. Sometimes, they may also recommend stool softeners.
- Vaginal pessary – This is a specific device used to support prolapsed organs.
Surgery
When nonsurgical options do not help, doctors may recommend posterior colporrhaphy or colpocleisis. During posterior colporrhaphy, surgeons will remove damaged tissue and then stitch the healthy tissue together. In most cases, this surgery does not leave scars because it is performed through the vagina.
Frequently Asked Questions
What happens if a rectocele is not treated?
If you ignore the symptoms and do not get treatment, the condition often worsens over time and may cause serious health problems that will impact your quality of life.
Is a rectocele a hernia?
In general, this condition is very similar to a hernia in which the rectum bulges (herniates) into the vaginal wall. However, doctors classify this condition as a pelvic organ prolapse, not a hernia. Consult with your physician for more details.
What should you not do with a rectocele?
You should avoid straining during bowel movements, heavy lifting, and other activities that put extra pressure on the pelvic floor (such as high-impact exercises). Moreover, dietary changes are also important because they help prevent constipation. Ask your healthcare provider if you have any other questions.
