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Rectocele

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A posterior vaginal prolapse, commonly known as a rectocele, develops when the tissue connecting the rectum to the vagina weakens or tears. This causes the rectum to push into the vaginal wall, resulting in a bulge in the tissue. While mild prolapses may not cause any symptoms, larger prolapses can cause discomfort and difficulty with bowel movements.

Symptoms of Posterior Vaginal Prolapse

A mild rectocele may not cause symptoms; however, more severe cases can result in:

  • A soft bulge of tissue in the vagina that can protrude through the opening.
  • Difficulty with bowel movements or the need to support the vaginal wall with fingers while passing stool (known as splinting).
  • A rectum pressure or fullness sensation.
  • After a movement, you may feel that your bowel is not completely empty.
  • Sexual concerns include vaginal looseness and embarrassment.

Causes

Pressure or injury to the pelvic floor can result in posterior vaginal prolapse. Contributing factors are:

  • Tearing during labour, as well as delivery by forceps.
  • The constant straining due to constipation or lifting heavy weights.
  • Coughing that persists due to a condition such as bronchitis.
  • Obesity causes increased pelvic pressure.
  • Aging causes weaker muscles and reduced elasticity.

Diagnosis

The diagnosis is usually made during a pelvic examination, which may include:

  • Bearing down as if having a bowel movement will reveal the size and location of the prolapse.
  • Tightening the pelvic muscles to test muscle strength.
  • In rare circumstances, other tests, which include MRI, X-rays, or bowel geography (to assess rectal emptying), may be performed to guide treatment options.

Prevention

To reduce the danger or prevent the progression of posterior vaginal prolapse:

  • Try to perform Kegel exercises regularly to strengthen your pelvic floor muscles, especially after childbirth.
  • Drink plenty of fluids and eat fiber-rich foods like fruits, vegetables, and whole grains to avoid constipation.
  • Avoid heavy lifting and use proper lifting technique.
  • Manage chronic coughing or bronchitis while avoiding smoking.
  • Maintain a healthy weight to relieve pelvic pressure.

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