Rectocele: Types, symptoms, causes, and diagnosis

A rectocele is a type of pelvic organ prolapse. It happens when the supporting ligaments and muscles weaken in the pelvic floor. Other names for a rectocele are a posterior vaginal wall prolapse or proctocele.

Childbirth, age, and a range of other factors can cause the normally tough, fibrous, sheet-like divider between the rectum and vagina to weaken.

A bulge may protrude as a hernia into the back of the vagina during a time of straining, such as a bowel movement.

A rectocele can lead to constipation and discomfort, but if it is small, there may be no symptoms.

Most people can treat a rectocele at home, but a severe case may need surgery.


A rectocele can lead to constipation
A rectocele happens when the pelvic floor weakens. It can lead to constipation.

A rectocele is one type of pelvic organ prolapse. In a woman, the rectum bulges into the back wall of the vagina.

Other types of prolapse are:

anterior vaginal wall prolapse, or cystocele, where the urinary bladder bulges into the front wall of the vagina

uterine prolapse, when the uterus sags down into the vagina

vault prolapse, in which the top (vault) of the vagina bulges down after a hysterectomy

A pelvic prolapse can vary in severity. Some people may experience different types of prolapse at the same time, such as both an anterior and posterior vaginal wall prolapse.

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A rectocele usually happens with pregnancy and childbirth, but the risk also increases with age, and other factors can play a role.

The underlying cause is a weakening of the pelvic support structures and of the rectovaginal septum, the layer of tissue that separates the vagina from the rectum.

Pregnancy and childbirth

Pregnancy and delivery can lead to a rectocele.
Pregnancy and delivery are major factors in the development of a rectocele.

It is more likely to occur as a result of childbirth if the baby was large (weighing over 9 pounds) if labor was prolonged, or if there was a multiple birth, for example, twins.

The more vaginal deliveries a woman has had, the more chance she has of developing a rectocele.

The risk is lower with a cesarean delivery, but a rectocele can still happen.

Older age

By the age of 50 years around half of all women have some symptoms of a pelvic organ prolapse, and by the age of 80 years, over 1 in every 10 will have had surgery for prolapse.

If the rectocele is small, the person may not notice it. If it is large, they may notice tissue protruding through the vaginal opening. There may be some discomfort, pressure, and, in some cases, pain.

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