The treatment of rectocele (also known as posterior vaginal prolapse) depends on the severity of its symptoms, and surgery is the only definitive treatment to fix it.
As it is a structural (anatomical) defect, you cannot fix a rectocele by natural means alone. However, you can follow some simple lifestyle tips to relieve its symptoms. Here is what you can do:
- Avoid constipation by following a healthy diet and regular exercise
- Take a stool softener to keep your bowel movements soft
- Have plenty of water throughout the day (6-8 ounces)
- Keep weight under check
- Avoid straining at stools (bearing down worsens the rectocele)
- Avoid heavy lifting
- Control coughing (you can use over the counter cough suppressants)
- Do pelvic floor muscle-strengthening exercises
A high-fiber (25 grams/day) diet is a healthy option that helps in treating constipation as well as is useful in controlling weight gain. You can increase your fiber intake by replacing processed foods, fatty foods, and meat with plenty of fruits and vegetables in your diet. Adequate intake of water and fibers will help you to pass softer, bulkier stools, thereby avoiding the need to strain at stools.
Pelvic floor exercises, such as Kegel exercises, strengthen your pelvic muscles. Here is how you can do them:
- Try tightening your pelvic floor muscles slowly for 3 seconds.
- You will feel like you are lifting them or like you are holding your pee.
- Then release for 3 seconds.
- Do this 10 times at a stretch. This is one set.
You should do one set of Kegel exercises 2-3 times a day. If you cannot perform a set of 10 on your first day, start with a smaller set as much as you can tolerate and build up gradually over time.
A nonsurgical measure like using a vaginal pessary helps support the bulging rectal tissue. A vaginal pessary is a plastic or rubber ring designed specially to be inserted into your vagina.
What is the main cause of a rectocele?
A rectocele is the bulging of the rectum into the back of the vagina. It is caused mainly by the weakening of the band of tissue that separates the rectum from the vagina. This weakening can be a result of any of the factors that include:
- Old age
- Multiple vaginal childbirths
- Instrument-assisted delivery (for example, the use of forceps)
- Repeated surgeries of the vagina, cervix, uterus, rectum, or anus
- Chronic constipation
What does rectocele look like?
A small rectocele usually causes no signs or symptoms. Over time, you may experience:
- Feeling a soft bulge in your vagina (that may even come out on straining at stools)
- A sensation of heaviness in the rectum
- Difficulty in passing stools
- A feeling of incomplete evacuation of bowels
- Frequent urge to have bowel movements in a day
- Discomfort during sex
- Vaginal bleeding
How is a rectocele diagnosed?
Your doctor will take your complete medical history and ask you a few questions regarding your bowel movements and rectal as well as vaginal complaints.
Next, the doctor will perform a pelvic examination that includes mainly, examining your vagina and rectum to look for features of rectocele and check if any other organ has also prolapsed. During this test, they will assess the strength of your pelvic floor muscles and the severity of the rectocele.
The doctor will order a few tests that include:
When do I need surgery for rectocele?
A rectocele does not heal on its own. It requires medical therapy and/or surgical treatment. If left untreated, it can worsen the existing symptoms and affect your quality of life greatly. However, not everyone will need immediate surgery. The reasons for which you need surgery for rectocele are:
- The rectocele prolapse protrudes outside your vagina making defecation and sex uncomfortable.
- Apart from the rectum, other organs in the pelvic region, such as the vaginal wall or bladder, have also collapsed into the vagina.
Posterior vaginal prolapse (rectocele). Available at: https://www.mayoclinic.org/diseases-conditions/rectocele/diagnosis-treatment/drc-20353419
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