Rectocele
A rectocele is a type of pelvic organ prolapse in which the rectum bulges forward into the back wall of the vagina. This occurs when the supportive tissue between the rectum and vagina weakens or stretches, often due to childbirth, chronic straining, aging, or prior pelvic surgery. Some rectoceles cause no symptoms, while others may lead to difficulty with bowel movements, pelvic pressure, or a sensation of bulging.
What is it?
A rectocele forms when the tissue separating the rectum and vagina—the rectovaginal septum—weakens, allowing the rectum to push forward. This can make it harder to pass stool, as part of the rectum may balloon outward instead of pushing stool forward. Causes include childbirth injuries, long-term straining, chronic coughing, or weakening of connective tissues with age.
MRI or dynamic pelvic imaging can help evaluate the size of a rectocele, the degree of pelvic organ descent, and whether other types of prolapse coexist. These studies help guide treatment decisions, especially if symptoms are significant or surgery is being considered.
Important to Know
Rectoceles range from mild to severe, and treatment depends on symptoms rather than size alone. Many people improve with pelvic floor physical therapy and adjustments like increased fiber intake. Surgical repair may be recommended when symptoms affect daily life or bowel function.
Red flag symptoms include severe pelvic pain, inability to pass stool despite urgent need, bleeding, or new urinary problems. These may indicate complications or a different underlying pelvic condition requiring prompt evaluation.