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Rectocele

Definition


Disease: Rectocele Rectocele
Category: Surgical diseases

Disease Definition:

When the fascia which is a wall of fibrous tissue separating the rectum from the vagina, becomes weakened, allowing the front wall of the rectum to bulge into the vagina, a condition called rectocele occurs.

 

can be caused by childbirthprocesses that put pressure on the fascimenopause, when en that helps pelvic tissues sreases, rectoceles occur.

 

The rectocele may create a noticeable bulge of tissue through the vaginal opening when it is large; and even though the bulge is rarely painful, but it can be uncomfortable. However, the rectocele may cause no signs or symptoms when it's small.

 

Self-care measures and other nonsurgical options are often effective when treatment of rectocele is necessary. But in severe cases, surgical repair may be required.
 

Work Group:


Symptoms, Causes

Symptoms:

A small, mild rectocele may not cause any signs or symptoms. In other cases, the followings may be noticed: 

 

  • Difficulty having a bowel movement
  • A feeling that the rectum has not completely emptied after a bowel movement
  • A soft bulge of tissue in the vagina that may or may not protrude through the vaginal opening
  • Difficulty controlling the passage of stool
  • Sensation of rectal pressure or fullness
  • The need to press one's fingers on the bulge in the vagina to help push stool out during a bowel movement

 

With rectocele, many women also experience related conditions such as:

 

  • Uterine prolapse, the condition in which the uterus descends into the vagina
  • Cystocele, a condition in which the bladder bulges into the vagina
  • Enterocele, in which the small intestines push down into the vagina
     

Causes:

The most common causes of rectoceles are pregnancy and delivery. It's because during pregnancy, labor and delivery, the muscles, ligaments and fascia that hold and support the vagina become stretched and weakened. This means that a woman’s risk of developing a rectocele will be increased the more pregnancies she has. 

 

Rectocele doesn't develop in everyone who has delivered a baby as some women have very strong fascia, ligaments and supporting muscles. Women who have only Caesarean deliveries are less likely to develop a rectocele.

 

Other conditions and activities that can put pressure on the pelvic floor and cause a rectocele include:

 

  • Repeated heavy lifting
  • Chronic cough or bronchitis
  • Being overweight or obese
  • Chronic constipation or straining with bowel movements

 

The risk of experiencing a rectocele might increase due to the following factors:

Childbirth: 

There's a higher risk of developing a rectocele when having vaginally delivered multiple children. There might be higher risk in the case of having tears in the tissue between the vaginal opening and anus (perineal tears) and incisions that extend the opening of the vagina (episiotomies) during childbirth.

Having a hysterectomy: 

Having the uterus removed may contribute to weakness in the ligaments, muscles and fascia surrounding the vagina.

Genetics: 

Although some women are born with stronger connective tissues in their pelvic area, but others are born with weaker connective tissues, making them naturally more susceptible to rectoceles.

Obesity: 

A high body mass index is linked to an increased risk of rectocele though the reasons aren't entirely clear. The chronic stress that excess body weight places on pelvic floor muscles may be the cause of this.

Aging: 

As a person grows older, he/she naturally loses muscle mass, elasticity and nerve function, causing muscles to stretch or weaken. That's why the risk of experiencing a rectocele increases as a woman grows older. 
 

Complications

Complications:

None

Treatments:

The severity of the rectocele will determine the type of treatment. With few or no obvious symptoms, no treatment or simple self-care measures work well, such as performing exercises called Kegels to strengthen the pelvic area muscles if the condition is mild. 

 

The following may be recommended if measures mentioned above fail to help:

Pessary:

The rubber or plastic ring inserted in the vagina to support the bulging tissues is called a vaginal pessary. There are many types of pessaries, including some that the doctor must remove periodically to clean, and others that the woman can remove herself to clean. Many women choose not to use this method because they have a high "hassle factor".

Surgery:

The patient may opt for surgery if her rectocele protrudes outside the vagina and is especially bothersome. More commonly, if the rectocele accompanies another condition such as a cystocele, an enterocele or uterine prolapse, surgery may be an option. In this case, all the problems can be repaired at the same time during surgical repair.

 

During surgery, the weakness in the connective tissue between the rectum and the vagina is repaired, usually by reinforcing the tissue with stitches. To support and strengthen the wall between the rectum and vagina, a mesh patch may be used in surgery.
 

Prognosis:

Not available

Expert's opinion

Expert's Name:
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Expert's opinion:

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