Posterior Vaginal Prolapse (Rectocele):Causes-Symptoms-Diagnosis-Treatment

 What Is Posterior Vaginal Prolapse (Rectocele)?

A rectocele is a situation where the tissue between your rectum and vagina weakens, causing your rectum to bulge onto your vagina's returned wall. Your rectum is the bottom part of your colon (large gut). Both your rectum and vagina live in position because the muscle mass and ligaments to your pelvis, known as your pelvic floor, maintain them in vicinity. When your pelvic floor weakens, these organs can shift and even fall onto each other.

What Is Posterior Vaginal Prolapse (Rectocele)?
Posterior Vaginal Prolapse

Rectocele is one shape of pelvic organ prolapse (POP), a condition where organs hunch because of a vulnerable pelvic floor. Often, rectocele occurs with different types of pelvic organ prolapse, where organs like your uterus or bladder shift out of the area, too.

Rectocele is also referred to as posterior vaginal wall prolapse.

  1. Digestive system

Medical terms

  • A posterior vaginal prolapse is a bulge of tissue into the vagina. It takes place while the tissue between the rectum and the vagina weakens or tears. This causes the rectum to push into the vaginal wall. Posterior vaginal prolapse is likewise referred to as a rectocele (REK-toe-seel).
  • Childbirth-related tears, chronic straining to bypass stool (constipation) and other sports that place stress on pelvic tissues can result in posterior vaginal prolapse. A small prolapse might not cause signs and symptoms.
  • With a huge prolapse, you may note a bulge of tissue that pushes via the opening of the vagina. To pass stool, you might need to assist the vaginal wall with your fingers. This is called splinting. The bulge can be uncomfortable, however it is rarely painful.
  • If wanted, self-care measures and different nonsurgical alternatives are often effective. For excessive posterior vaginal prolapse, you might need surgery to fix it.

Posterior vaginal prolapse (rectocele) is a protrusion of the posterior wall of the vagina which may cause urinary and fecal incontinence The rectocele is formed by herniation of the rectum into the posterior compartment in conjunction with weakening of the supportive connective tissue This condition may be present at birth or result from trauma to the region such as repeated heavy lifting chronic constipation and/or prolonged straining Another cause is aging which leads to hypertrophy and weakening of the pelvic floor muscles.

What does a rectocele feel like to touch?

A rectocele is felt as a bulge in the vagina It can be painful but it's typically not. The pain caused by a rectocele comes from pressure on other organs such as the bladder, uterus and/or bowel.

Can poop get stuck in a rectocele?

A rectocele can occur when the rectum pushes against the vagina causing the vaginal wall to bulge out During a rectocele repair an incision is made in the vagina and surgeons push the protruding tissue back into place The procedure takes about an hour and requires general anesthesia Recovery time ranges from a couple of weeks to a few months depending on how much correction needs to be done.

Symptoms Posterior vaginal prolapse (rectocele)

Some women with a rectocele have no signs. However, many women enjoy vaginal pressure, or the sensation that something is falling out of the vagina.A small posterior vaginal prolapse (rectocele) may cause no signs.

Otherwise, you may notice:

  • A soft bulge of tissue in the vagina that might come through the opening of the vagina

  • Trouble having a bowel movement

  • Feeling pressure or fullness in the rectum

  • 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 the vaginal tissue

Many ladies with posterior vaginal prolapse also have prolapse of other pelvic organs, inclusive of the bladder or uterus. A healthcare professional can examine the prolapse and communicate about options for surgical operation to restore it.

When to see a doctor

Sometimes, posterior vaginal prolapse does not cause troubles. But slight or extreme posterior vaginal prolapses is probably uncomfortable. See a fitness care provider if your signs and symptoms affect your daily life.

Causes Posterior vaginal prolapse (rectocele)

The pelvic organs are supported by using muscle mass, and sturdy tissues referred to as ligaments and fascia. Damage to any of these structures can bring about descent of the pelvic organs. Although the particular causes of POP are unknown, there are chance elements for growing POP which are associated with tissue, nerve or muscle weakness or harm. Previous pregnancies and vaginal births can cause injury to these systems and may be related to the development of POP at any time within the destiny. Other hazard factors encompass obesity, getting older, nerve and connective tissue disorders, and multiplied stomach stress due to heavy lifting or persistent coughing, as an example.

Posterior vaginal prolapse consequences from stress at the pelvic ground or trauma. Causes of multiplied pelvic ground stress consist of:

  • Birth-related tears

  • Forceps or operative vaginal deliveries

  • Long-lasting constipation or straining with bowel movements

  • Long-lasting cough or bronchitis

  • Repeated heavy lifting

  • Being overweight

Pregnancy and childbirth

The muscle groups, ligaments and connective tissue that guide the vagina stretch at some stage in being pregnant, labor and shipping. This could make those tissues weaker and much less supportive. The extra pregnancies you have got, the greater your hazard of growing posterior vaginal prolapse.

If you have simplest had cesarean deliveries, you're much less probable to expand posterior vaginal prolapse. But you continue to try to expand the condition.

Risk factors Posterior vaginal prolapse (rectocele)

Anyone with a vagina can develop posterior vaginal prolapse. However, the following may increase the danger:

  • Genetics. Some humans are born with weaker connective tissues inside the pelvic place. This makes them certainly more likely to develop posterior vaginal prolapse.

  • Childbirth. Having vaginally brought multiple children increases the threat of developing posterior vaginal prolapse. Tears inside the tissue among the vaginal opening and anus (perineal tears) or cuts that make the outlet of the vagina bigger (episiotomies) at some stage in childbirth may additionally pose a growth threat. Operative vaginal deliveries, and forceps in particular, grow the threat of developing this circumstance.

  • Aging. Growing older causes loss of muscle mass, elasticity and nerve function, which causes muscle groups to stretch or weaken.

  • Obesity. Extra body weight places stress on pelvic floor tissues.

Prevention Posterior Vaginal Prolapse (Rectocele)

You can not prevent a rectocele or pelvic organ prolapse. Still, you can put proper practices into locations that can strengthen your pelvic floor. Many of the same strategies used to manipulate moderate cases of rectocele can be used to reduce your chance of prolapse.To help keep posterior vaginal prolapse from getting worse, you may attempt to:

  • Perform Kegel exercises regularly. These sporting activities can improve pelvic ground muscle groups. This is in particular crucial after having a baby.

  • Treat and prevent constipation. Drink masses of fluids and devour high-fiber foods, consisting of end result, vegetables, beans and entire-grain cereals.

  • Avoid heavy lifting and lift correctly. Use your legs instead of your waist or back to lift.

  • Control coughing. Get treatment for a chronic cough or bronchitis, and don't smoke.

  • Avoid weight gain. Ask your fitness care company that will help you decide the great weight for you. Ask for recommendations on the way to shed pounds, if wished.

Diagnosis Posterior vaginal prolapse (rectocele)

At your appointment, your health practitioner will speak about your symptoms and review your clinical records with you. The medical doctor will then perform a bodily examination to decide the volume of the rectocele and perceive any secondary prolapses, if present. Rarely, imaging tests which include ultrasound or MRI may also be executed.

A diagnosis of posterior vaginal prolapse regularly happens during a pelvic examination of the vagina and rectum.

  1. Endoscopy

The pelvic exam might involve:

  • Bearing down As though having a bowel movement. Bearing down might reason the prolapse to bulge, revealing its length and area.

  • Tightening pelvic muscles As though stopping a movement of urine. This check examines the strength of the pelvic muscle tissue.

You may fill out a questionnaire to assess your circumstance. Your answers can tell your fitness care provider about how the bulge extends into the vagina and what sort of it impacts your life. This statistics allows guide remedy choices.

Rarely, you might need an imaging test:

  • MRI or an X-ray can determine the size of the tissue bulge.

  • Defecography Is a take a look at to check how well your rectum empties. The process combines the use of a contrasting agent with an imaging examination, such as X-ray or MRI.

How is posterior wall prolapse treated?

Posterior wall prolapse can be treated by making lifestyle changes and undergoing a pessary a vaginal device or surgery When the condition is mild it can be managed with diet and exercise changes To reduce constipation and straining during bowel movements eat more high-fiber foods including whole grains and fresh fruits and veggies Cut back on red meat refined carbohydrates and caffeine Exercise regularly to strengthen abdominal muscles.

Can a rectocele be repaired without mesh?

A rectocele is a common but treatable condition that leads to the bulging of the rectum into the vagina It often occurs after childbirth or as a result of aging A rectocele can be treated with non-surgical procedures including pelvic floor therapy but surgery may be needed in some cases Non-surgical options include exercises to strengthen your pelvic floor and vaginal tightening techniques such as the use of vaginal cones or pessaries If these treatments do not work surgery may be required If you are considering surgery for a rectocele it is important to find out if a mesh sling procedure will be used.

What happens if a rectocele goes untreated?

A rectocele is a bulge of the vaginal wall that pushes against the rectum causing it to protrude This bulge can cause irritation and pain because of pressure on the rectum Over time the condition can worsen and lead to fecal incontinence A rectocele can be treated with exercises but surgery might be needed if the problem does not improve.

Treatment Posterior vaginal prolapse (rectocele)

Mild rectoceles may be controlled with pelvic floor physical games to bolster your pelvic ground muscular tissues. Your healthcare company can also suggest a pessary. A vaginal pessary is a detachable device inserted into your vagina to support prolapsed organs.

With slight to more severe prolapse, your healthcare issuer may also suggest surgical procedure to restore the rectocele.

Treatment depends on how severe your prolapse is. Treatment may involve:

  • Observation. If the posterior vaginal prolapse causes few or no symptoms, easy self-care measures — together with performing Kegel physical games to reinforce pelvic muscle mass — would possibly provide remedy.

  • Pessary. A vaginal pessary is a silicone device which you put into the vagina. The tool helps support bulging tissues. A pessary ought to be removed regularly for cleansing.


Surgery to fix the prolapse might be needed if:

  • Pelvic ground strengthening sporting activities or using a pessary does not manipulate your prolapse symptoms well enough.

  • Other pelvic organs are prolapsed in conjunction with the rectum, and your signs and symptoms honestly trouble you. Surgery to restore every prolapsed organ may be done at the equal time.

Surgery regularly includes disposing of more, stretched tissue that bureaucracy the vaginal bulge. Then stitches are placed to assist pelvic structures. When the uterus is likewise prolapsed, the uterus would possibly want to be removed (hysterectomy). More than one sort of prolapse can be repaired for the duration of the same surgical operation.

Lifestyle and home remedies

Sometimes, self-care measures provide alleviation from prolapse signs and symptoms. You may want to try to:

  • Perform Kegel exercises to strengthen pelvic muscles

  • Avoid constipation by eating high-fiber foods, drinking plenty of fluids and, if needed, taking a fiber supplement

  • Avoid bearing down during bowel movements

  • Avoid heavy lifting

  • Control coughing

  • Achieve and maintain a healthy weight

Kegel exercises

Kegel sporting events make stronger pelvic ground muscle tissues. A strong pelvic ground provides better assistance for pelvic organs. It also would possibly relieve bulge signs that posterior vaginal prolapse can cause.

To perform Kegel exercises:

  • Find the right muscles. To find your pelvic ground muscles, try preventing urine midstream while you use the toilet. Once you recognize where these muscular tissues are, you can practice those sporting activities. You can do the sporting events in any role, despite the fact that you might discover it easiest to do them lying down in the beginning.

  • Perfect your technique. To do Kegels, imagine you're sitting on a marble and tighten your pelvic muscle mass as if you're lifting the marble. Try it for 3 seconds at a time, then relax for a count of three.

  • Maintain your focus. For pleasant outcomes, cognizance on tightening simplest your pelvic floor muscle tissue. Be careful not to flex the muscle mass for your stomach, thighs or buttocks. Avoid keeping your breath. Instead, breathe freely at some point of the exercises.

  • Repeat three times a day. Aim for at least three sets of 10 to 15 repetitions a day.

Kegel physical games can be mostly a hit while they are taught through a bodily therapist or nurse practitioner and reinforced with biofeedback. Biofeedback makes use of tracking gadgets to let you understand that you're tightening the proper set of muscle tissues within the right way.

Preparing for your appointment

For posterior vaginal prolapse, you may want to see a health practitioner who specializes in girl pelvic floor conditions. This type of medical doctor is referred to as a urogynecologist.

Here's a few information to help you get ready for your appointment.

What you can do

Make a list of:

  • Your symptoms and when they began

  • All medicines, vitamins and supplements you take, including doses

  • Key personal and medical information, including other conditions, recent life changes and stressors

  • Questions to ask your healthcare provider

For posterior vaginal prolapse, a few primary inquiries to ask your care issuer consist of:

  • What can I do at home to ease my symptoms?

  • Should I restrict any activities?

  • What are the chances that the bulge will grow if I don't do anything?

  • What treatment approach do you think would be best for me?

  • What are the chances that my condition will come back after I have surgery?

  • What are the risks of surgery?

Be sure to ask any other questions that occur to you during your appointment.

What to expect from your healthcare provider

Your provider is likely to ask you a number of questions, including:

  • Do you have pelvic pain?

  • Do you ever leak urine?

  • Have you had a severe or ongoing cough?

  • Do you do any heavy lifting in your job or daily activities?

  • Do you strain during bowel movements?

  • Has anyone in your family ever had pelvic organ prolapse or other pelvic problems?

  • How many children have you given birth to? Were your deliveries vaginal?

  • Do you plan to have children in the future?

General summary

  1. A rectocele is a kind of prolapse wherein the supportive wall of tissue among a girl’s rectum and vaginal wall weakens. Without the support of those pelvic floor muscle tissues and ligaments, the front wall of the rectum sags and bulges into the vagina, and in severe instances, protrudes out of the vaginal opening.
  2. A rectocele isn't always the identical thing as rectal prolapse. Rectal prolapse is a protrusion or prolapse of the rectum thru the anal starting.

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