Rectocele

A rectocele is a type of pelvic organ prolapse that occurs when the rectum bulges into the vagina, causing a bulge or protrusion in the vaginal wall. This condition is often associated with other forms of pelvic organ prolapse, such as cystocele (bladder prolapse) and uterine prolapse.

Causes and Risk Factors

The causes and risk factors for rectocele include:

• Childbirth: Vaginal delivery can cause stretching or tearing of the vaginal tissues, leading to a rectocele.
• Aging: Weakening of the pelvic muscles with age can contribute to the development of a rectocele.
• Constipation: Straining during bowel movements can put pressure on the rectum and vagina, increasing the risk of a rectocele.
• Hysterectomy: Removal of the uterus can cause changes in the pelvic anatomy that increase the risk of a rectocele.
• Obesity: Excess weight can put additional strain on the pelvic muscles, contributing to the development of a rectocele.

Symptoms

The symptoms of a rectocele may include:

• A bulge or protrusion in the vaginal wall
• Difficulty emptying the bowels
• Constipation
• Painful intercourse
• Vaginal discomfort or pressure
• Leakage of stool or gas during bowel movements

Diagnosis

A rectocele is typically diagnosed through a physical examination, including a pelvic exam. The doctor may also use imaging tests such as:

• Ultrasound
• Magnetic Resonance Imaging (MRI)
• Defecography: A special type of X-ray that shows the movement of stool through the rectum and anus.

Treatment Options

The treatment options for a rectocele depend on the severity of the condition and may include:

• Conservative management: Lifestyle changes such as dietary modifications, pelvic floor exercises (Kegel exercises), and bowel habits.
• Surgery: Surgical repair of the rectocele, which may involve repairing the vaginal wall or removing excess tissue.

Prevention

To prevent a rectocele, it is recommended to:

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

Frequently Asked Questions (FAQs)

What is a rectocele?
A bulge in the wall of the vagina caused by the rectum protruding into it.

What causes a rectocele?
Weakened vaginal and pelvic floor muscles, often due to childbirth or aging.

What are the symptoms of a rectocele?
Difficulty emptying bowels, constipation, and feeling of bulge in vagina.

How is a rectocele diagnosed?
Physical exam, medical history, and possibly imaging tests like ultrasound.

Can a rectocele be treated without surgery?
Yes, with pelvic floor exercises, bowel management, and lifestyle changes.

What are the surgical options for treating a rectocele?
Repair of vaginal wall, sacrospinous ligament suspension, and mesh repair.

Are there any risks associated with rectocele surgery?
Infection, bleeding, and recurrence of symptoms.

Can a rectocele be prevented?
Maintaining strong pelvic floor muscles through exercise and managing constipation.

How common is a rectocele?
Common in women who have given birth vaginally, especially those over 40.

Does a rectocele affect sexual function?
Possibly, due to discomfort or feeling of bulge during intercourse.