Posterior prolapse (rectocele)
Posterior prolapse (rectocele)
A posterior prolapse occurs when the thin wall of fibrous tissue (fascia) that separates the rectum from the vagina weakens, allowing the vaginal wall to bulge. Posterior prolapse is also called a rectocele (REK-toe-seel) because typically, though not always, it's the front wall of the rectum that bulges into the vagina.
Childbirth and other processes that put pressure on the fascia can lead to posterior prolapse. A small prolapse may cause no signs or symptoms. If a posterior prolapse is large, it may create a noticeable bulge of tissue through the vaginal opening. Though this bulge may be uncomfortable, it's rarely painful.
If needed, self-care measures and other nonsurgical options are often effective. In severe cases, you may need surgical repair.
A rectocele occurs when the wall of fibrous tissue that separates a woman's rectum from her vagina weakens, allowing the front wall of the rectum to bulge into the vagina. ...
A small posterior prolapse may cause no signs or symptoms. Otherwise, you may notice:
Many women with posterior prolapse also experience related conditions, such as:
When to see a doctor
In moderate or severe cases, however, posterior prolapse can be bothersome or uncomfortable. Make an appointment with your doctor if:
Increased pelvic floor pressure
Pregnancy and childbirth
Not everyone who has had a baby develops posterior prolapse. Some women have very strong supporting muscles, ligaments and fascia in the pelvis and never have a problem. Women who have only had cesarean deliveries are less likely to develop posterior prolapse. But even if you haven't had children, you can develop posterior prolapse.
The following factors may increase your risk of experiencing posterior prolapse:
Preparing for your appointment
Make an appointment with your family doctor or gynecologist if you have symptoms of posterior prolapse that bother you or interfere with your normal activities.
Here's some information to help you prepare for your appointment and know what to expect from your doctor.
What you can do
For posterior prolapse, some basic questions to ask your doctor include:
During your appointment, don't hesitate to ask other questions as they occur to you.
What to expect from your doctor
Tests and diagnosis
In most cases, your doctor diagnoses posterior prolapse during a pelvic examination of your vagina and rectum.
Possible tests for rectocele include:
Treatments and drugs
Treatment approaches depend on the severity of the posterior prolapse. Options include:
Your doctor will likely suggest surgery if you have anterior, apical or uterine prolapse in addition to posterior prolapse. In these cases, surgical repair for each condition can be completed at the same time.
Using a vaginal approach, surgery usually consists of removing excess, stretched tissue that forms the posterior prolapse. Occasionally, the surgical repair may involve using a mesh patch to support and strengthen the wall between the rectum and vagina.
If you're thinking about becoming pregnant, delay surgery until after you're done having children. Using a pessary may help relieve your symptoms in the meantime.
Pessaries come in many shapes and sizes. The device fits into your vagina and provides support to vaginal tissues displaced by pelvic organ prolapse. Your doctor can fit you for a pessary and help ...
Lifestyle and home remedies
Depending on the severity of the condition, these self-care measures may provide the relief you need:
To perform Kegel exercises, follow these steps:
Ask your health care provider for feedback on whether you're using the right muscles. Kegel exercises may be most successful when they're taught by a physical therapist and reinforced with biofeedback. Biofeedback involves using monitoring devices that help ensure you're tightening the proper muscles, with optimal intensity and length of time.
Once you've learned the proper method, you can do Kegel exercises discreetly just about anytime, whether you're sitting at your desk or relaxing on the couch.
To reduce your risk of worsening posterior prolapse, try these self-care measures:
Last Updated: 2012-08-01
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