Rectocele: Causes, Symptoms, and Treatment
Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Rectocele?
A gynecologist, a doctor who treats women's reproductive health, often treats a rectocele. A colorectal surgeon, a doctor who treats the bowel and rectum, may also help. A pelvic floor physical therapist can teach exercises. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is a rectocele?
A rectocele is a type of pelvic organ prolapse. Part of the rectum pushes through a weak spot into the back wall of the vagina. Up to two-thirds of women who have had children have some degree of rectocele. Most of them have no symptoms and do not seek care.
Symptoms
Most women with a rectocele have no symptoms. When symptoms do appear, they can include:
- A bulge in the back wall of the vagina that gets worse with straining.
- Constipation and a feeling that the bowel is not fully empty.
- Pressure or pain in the pelvis.
- Pain during sex, called dyspareunia.
- Pressing on the vaginal bulge with a finger to help pass stool.
In more advanced cases, tissue can reach past the vaginal opening. This raises the risk of irritation, bleeding, infection, and sores.
Causes and who gets it
A rectocele forms when the wall between the rectum and the vagina loses its strength. Having several vaginal births, a long labor, or a birth injury raises the risk. Women who had a hysterectomy, which is surgery to remove the uterus, are also more likely to develop one. Other risk factors include older age, obesity, and the years after menopause. Long-term constipation, hard straining, and a long-lasting cough can also add to the risk. Symptoms often start between ages 50 and 60.
How doctors diagnose it
A rectocele is mainly found from your health history and a physical exam. Most of the time, no extra lab or imaging tests are needed. The exam can include a belly, vaginal, and rectal exam.
Some women need more tests. These can include:
- Defecography, an imaging test that can help confirm a rectocele.
- Dynamic MRI, which shows the pelvic organs moving during straining.
- Ultrasound of the pelvic floor.
- Anorectal manometry, which checks how the rectum and anus muscles work together.
Bleeding from the rectum or weight loss with trouble passing stool needs a check for other serious causes.
Treatment
Conservative care is the first-line treatment for most women, especially when symptoms are mild. It starts with a high-fiber diet, more fluids, and less straining. Pelvic floor physical therapy, including Kegel exercises, may help. Kegel exercises were more helpful for prolapse of the front wall than for rectocele. Biofeedback, a training method that teaches the muscles to work together, may help some women.
A vaginal pessary may help women who still have symptoms. A pessary is a silicone device that supports the pelvic organs. Side effects can include discharge, odor, irritation, and bleeding.
Surgery is usually kept for women with serious bowel symptoms or a bothersome bulge that does not improve with other care. No single operation has been shown to be best for everyone.
When to see a doctor
A doctor can check you if you notice a bulge in the vagina or have trouble passing stool, which are typical symptoms of a rectocele. If you also have rectal bleeding or weight loss along with trouble passing stool, a doctor should check for other serious causes, such as colorectal cancer or inflammatory bowel disease.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. This kind of doctor can do a first exam and look for other causes of bowel symptoms. They can also help with fiber and fluid habits and send you to a pelvic floor therapist or surgeon.
Common questions
Is a rectocele dangerous?
No, a rectocele is not life-threatening. It can still cause vaginal discomfort, constipation, and pain during sex.
Can a rectocele go away on its own?
A mild rectocele can improve on its own in some women. A more advanced rectocele is more likely to get worse.
Will I need surgery for a rectocele?
Most women with a rectocele do not need surgery. Diet changes and pelvic floor therapy come first, and a pessary may be tried if symptoms continue.
What is a pessary for a rectocele?
A pessary is a silicone device placed in the vagina to support the pelvic organs. It may keep some women from needing surgery.
Sources
- StatPearls (NCBI Bookshelf) - Rectocele
- Clinics in Colon and Rectal Surgery (PubMed Central) - Functional Disorders: Rectocele
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
