Rectocele is a condition that affects women, where the front wall of the rectum bulges into the front wall of the vagina. The condition is common in women, however most women do not experience symptoms.
What causes rectocele?
Rectocele occurs due to thinning of the tissues or septum between the vagina and rectum and weakening of the pelvic floor muscles. Other pelvic organs such as the bladder (cystocele) or small intestine (enterocele) can bulge into the vagina causing similar symptoms.
Many factors can lead to weakening of the pelvic floor and thus rectocele including childbirth, constipation and straining to have bowel movements, and gynecological (hysterectomy) or rectal surgeries.
What symptoms are associated with rectocele?
Most individuals with a rectocele do not experience symptoms. Rectocele may be discovered incidentally during a routine pelvic or rectal exam. When rectocele is large, symptoms may include difficulty with complete evacuation during bowel movements, the need to press against the vagina or perineum (space between the vagina and anus) to have a bowel movement, straining to have bowel movements, constipation, or urge to have multiple bowel movements throughout the day. These symptoms are usually caused by stool becoming stuck in the bulge of the rectum as it protrudes into the back wall of the vagina during a bowel movement. Patients may also have pain with sexual intercourse, or a sense of fullness in the vagina.
How is rectocele diagnosed?
Rectocele may be found incidentally during a physical exam. If there are no symptoms associated with rectocele, then no treatment is necessary. However, if an individual is experiencing any of the above symptoms related to a rectocele Dr. Zaghiyan may recommend further testing such as a special x-ray test known as defecography or dynamic MRI to see the size of the rectocele and its relationship to your bowel movements.
How is rectocele treated?
If you are constipated Dr. Zaghiyan may recommend a diet high in fiber and water intake to make your stool softer and avoid straining associated with constipation. This will help reduce the chance of your rectum bulging into your vagina. If you have loose stools or diarrhea, a high fiber diet may help bulk your stools and reduce the number of bowel movements you are having. Other medications may be recommended to help with your stool consistency. It may also be helpful to apply pressure to the back of your vagina during bowel movements to help with evacuation if you are not already doing so.
If your symptoms continue despite medical management and are severe enough that they interfere with your daily life, then Dr. Zaghiyan may recommend surgery. There are several surgical options including vaginal, rectal, and abdominal surgeries to repair a rectocele. The goal of most surgeries is to remove the extra tissue that makes up the bulge of the rectocele and strengthening the wall between the rectum and vagina. Make an appointment for a consultation with Dr. Zaghiyan in her office in Los Angeles for a thorough evaluation and treatment recommendations.