Posterior Prolapse

A posterior prolapse, also known as a rectocele, is a type of pelvic organ prolapse that occurs when the rectum bulges into the back wall of the vagina. This condition can cause discomfort, pain, and difficulty with bowel movements.

Causes and Risk Factors

The causes and risk factors for posterior prolapse include:

• Childbirth: Vaginal delivery can weaken the muscles and tissues that support the rectum, leading to a posterior prolapse.
• Aging: Weakening of the muscles and tissues with age can contribute to the development of a posterior prolapse.
• Constipation: Straining during bowel movements can put pressure on the rectum and vagina, increasing the risk of a posterior prolapse.
• Obesity: Excess weight can put additional pressure on the pelvic floor muscles, contributing to the development of a posterior prolapse.
• Surgery: Previous surgeries, such as a hysterectomy, can increase the risk of developing a posterior prolapse.

Symptoms

The symptoms of posterior prolapse may include:

• A bulge or lump in the vagina
• Discomfort or pain during sex
• Difficulty with bowel movements, such as straining or feeling like the rectum is not emptying completely
• Leakage of stool or gas
• Feeling of pressure or heaviness in the vagina

Diagnosis

A posterior prolapse can be diagnosed through a physical exam, medical history, and possibly imaging tests such as:

• Pelvic exam: A healthcare provider will perform a pelvic exam to assess the position and condition of the rectum and vagina.
• Defecography: This is an imaging test that uses X-rays to evaluate the function of the rectum and anus during bowel movements.

Treatment Options

Treatment options for posterior prolapse may include:

• Lifestyle changes: Making dietary changes, such as increasing fiber intake, and practicing pelvic floor exercises can help manage symptoms.
• Physical therapy: A physical therapist can help strengthen the pelvic floor muscles and improve bowel function.
• Surgery: In some cases, surgery may be necessary to repair the prolapse and restore normal anatomy.

Prevention

To prevent posterior prolapse, it is recommended to:

• Maintain a healthy weight
• Avoid constipation by eating a high-fiber diet and staying hydrated
• Practice pelvic floor exercises, such as Kegel exercises, regularly
• Avoid heavy lifting and straining during bowel movements

Frequently Asked Questions (FAQs)

What is a posterior prolapse?
A condition where the rectum bulges into the vagina.

What causes posterior prolapse?
Weakened pelvic muscles and ligaments.

What are the symptoms of posterior prolapse?
Vaginal bulge, constipation, and discomfort.

How is posterior prolapse diagnosed?
Pelvic exam and medical history.

Can posterior prolapse be treated without surgery?
Yes, with pelvic exercises and pessaries.

What are pessaries for posterior prolapse?
Devices inserted into the vagina for support.

Can posterior prolapse be surgically repaired?
Yes, through various surgical procedures.

What are the risks of posterior prolapse surgery?
Infection, bleeding, and recurrence.

How long is recovery from posterior prolapse surgery?
Several weeks to several months.

Can posterior prolapse be prevented?
Possibly, with pelvic exercises and maintaining a healthy weight.