What is Rectocele?

Posterior vaginal wall prolapses or proctocele or rectocele is a type of pelvic organ prolapse. It is the result of the muscle and ligament weakness in the pelvic floor. A rectocele in simple terms, is a herniation or bulge. The rectovaginal septum is a tissue present between the vagina and the rectum; due to some reason this tissue becomes weak and stretches which leads to rectocele. To make it simpler, the front wall of the rectum bulges against the posterior of the vagina giving it a bulgy appearance.

What causes Rectocele?

The exact causes of rectocele are unknown but given below are a few possible causes of it:

1. Childbirth

Vaginal birth especially multiple births are said to be the primary cause of rectocele. Prolonged labour can stretch and weaken the muscle that supports the vagina which can results in rectocele.

2. Pregnancy

Pregnancy is beautiful but during pregnancy a woman’s body goes through a lot of changes which can affect the pelvic region of the body leading to rectocele.

3. Ageing

Pelvic organ prolapse is as common as 1 in every 10 women above the age of 50. This is because with age, the strength of the muscles in the pelvic region decreases and results in rectocele.

4. Other common causes of rectocele are:

  • A trauma from childbirth
  • Chronic straining of pelvic floor muscles
  • Straining with bowel movements
  • Persistent coughing or sneezing
  • Obesity
  • Heavy lifting
  • Sexual abuse during childhood
  • Menopause, due to the drop in the oestrogen level

What are the symptoms of Rectocele?

The symptoms of small posterior vaginal prolapse or rectocele are:

  • Difficult bowel movement
  • The pressure felt on the rectal region
  • A soft bulge into the vagina
  • A feeling of fullness in the rectum region even after the complete emptying of it
  • Looseness in the tone of the vaginal tissue

Are there any treatments for Rectocele?

There are three ways of treating Rectocele:

1. Surgery

Depending on the preference of the patient and the extent of the condition, different surgeries are selected. Some of the options are:

  • Sacral colpopexy
  • Uterosacral colpopexy
  • Sacrospinous colpopexy
  • Transvaginal mesh

During the operation, the surgeon removes the stretched or damaged tissue. Sometimes, they may use a mesh inlay to reinforce the wall between the vagina and the rectum.

2. Lifestyle and Home Remedies:

Following certain lifestyle and simple home remedies can also help, like:

    • Performing Kegel exercises
    • Avoiding strenuous exercises like weightlifting
    • Consuming high-fibre foods to prevent constipation
    • Shedding that extra weight
    • Controlling coughing

3. Medication

In a few cases the doctor may prescribe medicines like:

      • Stool softeners
      • Hormone replacement therapy
      • A vaginal pessary

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