Battle of the Bulge

Rectocele is a medical condition in which the front wall of the rectum bulges into the back wall of the vagina. A rectocele occurs when the tissue barrier between the rectum and vagina, called the rectovaginal septum, becomes weakened and thinned out over time.

Small rectoceles will generally cause no symptoms, while more severe cases will result in symptoms including:

  • Defecatory dysfunction such as difficulty during bowel movements
  • Feeling of a bulge or fullness in the vagina
  • Vaginal discomfort during intercourse
  • The protrusion of tissue from the vagina
  • Vaginal bleeding

Some women with a rectocele will experience the need to strain excessively during a bowel movement or have multiple bowel movements throughout the day; and because small pieces of stool may become trapped by the rectocele itself, some instances of fecal incontinence may occur as the pieces of stool eventually seep from the anus.

What’s the Pushback?

To properly diagnose a rectocele, a urogynecologist or other medical specialist will need to perform a female pelvic exam of both the vagina and the rectum using a bimanual method or the use of a speculum for visual identification. Digital rectal exams will uncover any weakness in the front rectal wall; and a specialized X-ray scan called a defecography will allow for an accurate visual confirmation of the rectocele. During the defecography, a contrast dye that has been inserted into the vagina, rectum, and bladder will be tracked as it passes through the body while the patient attempts to defecate. The presence of a rectocele will result in the patient’s inability to completely empty the rectum, and the X-ray will help document the size of the rectocele. An abnormal rectocele will measure greater than two centimeters in size and generally causes a significant retention of the contrast material used in the X-ray.

Calling In the Reinforcements

Unless a rectocele is causing significant symptoms, it should not require treatment. Before any treatment measures are taken, all options should be discussed and explored to determine the most effective method. Naturally, the most viable options will depend on the severity of the symptoms and the medical history of the patient, as some women will require surgical intervention while others may find relief with simple changes to their diet and lifestyle.

For women requiring surgery, they may be able to undergo open or laparoscopic surgery through the abdomen; other surgical approaches include entering through the anus, through the perineum, or through the vagina in order to remove the extra tissue that composes the rectocele and strengthen the tissue barrier between the rectum and the vagina.

Don’t let your health get pushed to the side! Give the caring, friendly experts at Coyle Institute a call today!