Due to weakening of the supporting tissues between the rectum and the vagina, rectocele causes the rectum to protrude into the back wall of the vagina. We explore the causes, symptoms, diagnosis, treatment, and prevention of rectocele here. It can cause discomfort and change in bowel movements.
Causes
A rectocele typically develops when the pelvic floor muscles and connective tissues supporting the rectum and vagina weaken.
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In childbirth, particularly vaginal delivery, the pelvic floor muscles and tissues can be stretched and weakened, increasing the risk of rectocele.
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Constipation or straining during bowel movements: Prolonged or frequent episodes of straining can weaken the pelvic floor's supporting structures.
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Natural aging processes can lead to loss of muscle tone and elasticity in the pelvic floor, making it more susceptible to rectocele.
Symptoms
Rectocele symptoms include:
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Vaginal bulges or lumps, particularly after bowel movements
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Incomplete or difficult emptying of the rectum during bowel movements
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Vaginal or rectum pressure or fullness
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Discomfort or pain during sexual activity (dyspareunia)
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Constipation or difficulty passing stool for a long period of time
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Fecal incontinence refers to the leakage of stool or mucus from the vagina
Diagnosis
Rectocele is diagnosed through a combination of medical history, physical examination, and diagnostic tests. Diagnostic procedures include:
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During a pelvic exam, a healthcare provider can check for rectocele and assess the strength and tone of the pelvic floor muscles.
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Defecography: This imaging test uses X-rays to visualize the rectum during defecation and identify structural or functional abnormalities.
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The rectum and colon may be examined for other causes of symptoms, such as polyps or tumors, during colonoscopy or sigmoidoscopy.
Treatment
The following treatments may be used to treat rectocele, depending on the severity of the symptoms:
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Mild symptoms can be alleviated with lifestyle modifications, such as diet changes to encourage regular bowel movements, pelvic floor exercises (Kegels) to strengthen muscles, and avoiding heavy lifting.
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A physical therapist specializing in pelvic floor rehabilitation can help strengthen pelvic floor muscles and improve rectocele symptoms.
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An intravaginal pessary, a removable device that supports the rectum and alleviates symptoms, may be recommended for some women.
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The pelvic floor may need to be surgically repaired in severe cases or when conservative measures are ineffective.
Prevention
Rectocele can be prevented by:
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Eat a high-fiber diet, stay hydrated, and avoid constipation to reduce the risk of rectocele by promoting regular bowel movements and reducing pelvic floor strain.
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Kegel exercises can help strengthen the pelvic floor muscles and prevent pelvic floor disorders like rectocele when performed regularly, especially during pregnancy, childbirth, and other activities that strain the pelvic floor.
