What is a rectocele?

A rectocele is a hernia or defect in the connective tissue between the rectum and the vagina. This causes a bulging of the rectum into the vagina and makes it very difficult for some women to have bowel movements. Also, patients can have complaints of pelvic pressure, pelvic pain, and difficulty with intercourse.

Rectocele is a condition in which the tissue that supports the floor of the vagina becomes so thin that the rectum actually bulges into the vagina, much like a hammock that has become loose over time. It's the equivalent of a dropped bladder, except it involves the back of the vagina, not the front. Instead of stool going down a straight tunnel, it gets trapped in a "turn in the road" -- hence the necessity to push down. "Splinting" is the term we use to describe the need to put manual pressure on the vagina or perineum in order for the stool to come out. Mild rectoceles require no treatment, but if it is bothersome, a minor surgical procedure can put things back where they belong.

In women, the rectum may bulge into the vagina because of weakening of the vaginal wall and other supportive tissue causing a rectocele. This can be caused by vaginal childbirth. Difficulties passing stool may result. Some women find it helps to place one or more fingers inside the vagina to help support the bulging tissue and facilitate a bowel movement.

A rectocele is a hernia in the wall that separates the rectum from the vagina.

A hernia is a bulge that forms when the support tissue within the wall is damaged or weakened. Other areas of support in the pelvis can also be damaged. For example, a hernia in the front wall of the vagina that separates it from the bladder is called a cystocele. The general name for these conditions is pelvic floor prolapse.

Many factors may cause damage to the pelvic floor. The most important is injury from giving birth. Aging, smoking, genetic factors, and chronic stress on the pelvic floor (from lifting and straining) may contribute to the development of prolapse.

Prolapse can be mild, causing no symptoms. It can also be quite uncomfortable when the condition becomes more pronounced.

Women with larger rectoceles will often feel pressure and a sense of "something falling down". They may have difficulty moving their bowels and sometimes need to brace the area near the rectum to evacuate their stools. Intercourse may be uncomfortable as the bulging tissue creates a partial blockage within the vagina.

Treatment is not required for prolapse that causes little or no symptoms. If prolapse is bothersome, several treatments are available.

A rectocele is a form of pelvic organ prolapse that occurs when the tissues and muscles that hold the end of the large intestine (rectum) in place are stretched or weakened. This results in the rectum moving from its natural position to press against and sometimes through the back wall of the vagina.

A rectocele usually develops when a woman's pelvic muscles become weak as a result of having children, aging, or having previous surgery. In rare cases, a rectocele may be present at birth (congenital).

A rectocele may become large or more obvious with straining or bearing down (for example, during a bowel movement). A rectocele may cause pain during sexual intercourse or difficulty when passing stool.

Many cases of rectocele do not cause symptoms and do not require treatment. If treatment is needed, a rectocele usually can be surgically corrected.