A rectocele is a type of pelvic organ prolapse where the rectum bulges into the back wall of the vagina. It happens when the tissues between them weaken, often after childbirth or with aging.
A rectocele develops when the pelvic floor and the wall between the rectum and vagina become weak. Pregnancy and vaginal birth are common causes, especially a long or difficult birth. Other factors include aging, lower estrogen after menopause, long-term constipation and straining, a long-term cough, heavy lifting and being overweight.
A small rectocele may cause no symptoms. Larger ones can cause a bulge or feeling of something coming down in the vagina, difficulty emptying the bowels, or needing to press on the vagina to finish a bowel movement. Some people feel discomfort during sex or pressure that gets worse at the end of the day.
Treatment depends on how much the symptoms affect daily life. Options a doctor may discuss include pelvic floor exercises, avoiding constipation, a vaginal pessary to support the vaginal wall, and surgery. A rectocele can happen together with other types of prolapse, such as uterine prolapse.
Some people with a rectocele find long periods of standing or heavy lifting uncomfortable. Easy access to toilets, a chance to change position, avoiding heavy lifting and time off for appointments or surgery can help. A GP is the first step for diagnosis and advice.
Sources: NHS, MedlinePlus.
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