RECTOCELE

Overview & Facts

A posterior prolapse or rectocele occurs when the thin fibrous tissue that separates the rectum from the vaginal weakens and allows the front wall of the rectum to buulge into the vagina. Childbirth and other processes that put intense pressure on this thin fascia usually cause posterior prolapse, though symptoms may not be so noticeable unless the prolapse is large.

Types & Symptoms

A small posterior prolapse may cause no signs or symptoms. Otherwise, if the prolapse is large, the symptoms include:

  • A soft bulge of tissue in your vagina that may or may not protrude through the vaginal opening
  • Difficulty having a bowel movement with the need to press your fingers on the bulge in your vagina to help push stool out during a bowel movement (“splinting”)
  • Sensation of rectal pressure or fullness
  • A feeling that the rectum has not completely emptied after a bowel movement
  • Sexual concerns, such as feeling embarrassed or sensing looseness in the tone of your vaginal tissue

Diagnosis & Medications

Diagnosis

A physician diagnoses posterior prolapse during a complete pelvic examination of the vagina and rectum.

 

Treatment

The treatment approaches depend on the severity of the posterior prolapse. Depending on the size or degree of discomfort, the following treatment options may be considered:

  • Observation for small, or uncomplicated prolapses
  • Pessary for support of bulging muscles
  • Surgery for definitive treatment

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