Rectocele

A rectocele is an abnormal bulging of the rectovaginal septum(which is normally a semi-rigid divider between the rectumand vagina) into the vaginal area.

Mild cases may simply produce a sense of pressure or protrusion within the vagina, and the occasional feeling that the rectum has not been completely emptied after a bowel movement. Moderate cases may involve difficulty passing stool(because the attempt to evacuate pushes the stool into the rectocele instead of out through the anus), discomfort or pain during evacuation or intercourse, constipation, and a general sensation that something is "falling down" or "falling out" within the pelvis. Severe cases may cause vaginal bleeding, intermittent fecal incontinence, or even the prolapseof the bulge through the mouth of the vagina, or rectal prolapsethrough the anus.

It can be caused by many factors, but the most common is childbirth, especially a difficult birth which involves the use of forcepsor a vaginal tearor episiotomy. The risk increases with the number of vaginal births, although it can also happen in women who have never borne a child. A hysterectomyor other pelvic surgery can be a cause, as can chronic constipation and straining to pass bowel movements. It is more common in older women than in younger ones; estrogenwhich helps to keep the pelvic tissues elastic decreases after menopause. Another cause which is often overlooked in younger women is severe sexual traumaduring childhood.

Treatment depends on the severity of the problem, and may include changes in diet (increase in fiber and water intake), pelvic floorexercises such as Kegel exercises, use of stool softeners, hormone replacement therapyfor post-menopausal women, insertion of a pessaryinto the vagina, and various forms of surgery(usually posterior colporrhaphy). Both gynecologistsand colorectal surgeonscan address this problem.

References

• eMedicine: Rectocele

This article is licensed under the GNU Free Documentation License.
It uses material from the http://en.wikipedia.org/wiki/Rectocele Wikipedia article Rectocele.