A rectocele or the vaginal prolapse (protrusion of the hind wall of the vagina) is a medical condition in which there is a bulging of the front wall of the rectum (the last part of the large bowel) into the back of the vagina. The treatment for rectocele is needed when symptoms are present. In the absence of any symptoms or signs, the doctor may advise:
- Regular checkup and observation
- Kegel exercises to strengthen the pelvic muscles
- Avoiding straining during stools and constipation by having a fiber-rich diet and plenty of fluids. Stool softeners may also be prescribed.
- Controlling cough
- Maintaining a healthy weight
- A vaginal pessary (a plastic or rubber ring, block, or plug inserted into the vagina) to support the bulging tissues. The pessary needs to be regularly examined and cleaned.
If the condition worsens or becomes more bothersome, surgery is advised. Surgery involves removing the excess tissue that forms the vaginal bulge. The wall is strengthened by placing stitches to support pelvic structures. Some surgeries may involve placing a mesh patch to support and strengthen the weakened area.
What is a rectocele?
A rectocele or posterior (hind) vaginal wall prolapse is a medical condition in which there is a bulging of the front wall of the rectum (the last part of the large bowel) into the back of the vagina. A rectocele occurs due to the weakening of the wall between the rectum and the vagina (the rectovaginal septum). This causes a bulge or herniation which may progress with time.
A rectocele may occur due to several reasons, such as:
- Multiple vaginal deliveries
- Trauma during childbirth due to the tearing of the pelvic tissue or the use of forceps or vacuum during delivery
- Chronic (long-term) constipation associated with straining during bowel movements
- Multiple surgeries in the pelvic area, such as surgeries on the vagina or the rectum
- Lifting heavyweights
- Being overweight or obese
- Chronic cough
What are the symptoms of a rectocele?
Most of the patients with a rectocele do not have any symptoms. Around 40% of the women with this condition are diagnosed during a routine checkup. The symptoms of a rectocele may include:
Rectal symptoms, such as
- Difficulty in having a bowel movement
- Feeling of the incomplete emptying rectum after a bowel movement
- Rectal pressure or fullness
- Fecal incontinence (uncontrolled passage of stools) and smearing
- Rectal pain
Vaginal symptoms, such as:
- A sensation of bulge or fullness in the vagina
- There may be swelling or tissue bulging out of the vagina
- Vaginal bleeding
- Discomfort during sexual intercourse
- Feeling of decreased vaginal tone
- Vaginal pain or discomfort
How long does a rectocele repair surgery take?
The duration of a rectocele repair surgery may vary depending on certain factors, such as the severity of the rectocele. The procedure on average takes around 1 hour to complete. The surgery is generally done by a reconstructive surgeon, who specializes in pelvic floor repair. A rectocele repair is usually done under general anesthesia (you sleep during the procedure).
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