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Prolapse | Rectum (Rectocele)

From the Pelvic Floor Articles List

Rectum prolapse - what is a rectocele?I believe I have a rectocele. What are my diagnostic and treatment options?


When the tissue between the rectum and the vagina thins, the front wall of the rectum can bulge into the back wall of the vagina creating a rectocele. This type of prolapse is also known as a posterior prolapse and is a very common condition.

The extent of the prolapse can dictate both diagnostic and treatment options. A small prolapse may cause no signs or symptoms and may only be discovered during a routine exam. In more severe cases, the rectum may cause a noticeable bulge in the vagina that leads to uncomfortable symptoms and issues with bowel movements.

Your doctor may perform a pelvic exam while you are lying down and standing up. This can allow him to determine if there is a prolapse and the extent of prolapse. Additionally, you may be asked to undergo a defecography. For this test, an enema with contrast material is given, then X-rays are performed as you have a bowel movement.

For those with no symptoms, expectant management is generally the course of action. Your doctor may monitor you periodically, and you should advise him of any changes in symptoms. Otherwise, no action is taken. Only when symptoms warrant is medical intervention necessary. These symptoms may include difficulty passing stool, the need to split to pass stool, pain with intercourse, and vaginal bleeding.

Non-surgical treatment options can include a high fiber diet, extra hydration, stool softeners, pelvic floor exercises, a pessary, and/or hormone therapy. Surgical options may involve strengthening the vaginal wall and removing any excess tissue. A hysterectomy is usually not necessary unless there are other pelvic organ prolapses that also involve the uterus. Treatment and surgery can be provided by a colorectal surgeon or gynecologist. For non-surgical options, a gastroenterologist may be able to help.

Each woman must weigh her own pros and cons to determine which treatment option is best for her. Additionally, the HysterSisters advocate seeking a second opinion before making any major decisions or scheduling a surgery. If you have multiple prolapses, the HysterSisters recommend consulting with a urogynecologist.


This content was written by staff of HysterSisters.com by non-medical professionals based on discussions, resources and input from other patients for the purpose of patient-to-patient support.

06-10-2013 - 02:18 PM


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