What Is A Rectocele, Symptoms, Causes, And How To Treat This Condition?


A rectocele is a bulge or herniation of the front wall of the rectum into the vagina. While not inherently dangerous, rectoceles can causesymptoms that negatively impact the quality of life. Understanding what a rectocele is, its causes, symptoms, and treatment options is important for women.

  • A rectocele is a bulge or herniation of the rectum into the vagina caused by weakened pelvic floor muscles.
  • Symptoms include a feeling of vaginal fullness, pressure, needing to press on the vagina to defecate, and difficulty emptying the bowels fully.
  • Pregnancy, childbirth, aging, menopause, chronic constipation, heavy lifting, and prior pelvic surgery increase risk.
  • Mild cases may not require treatment beyond Kegel exercises and bowel movement modifications.

What Is A Rectocele?

A rectocele develops when the thin wall of tissue between the rectum and vagina weakens, allowing the rectal wall to bulge into the vagina. This creates a pocket or pouch in the posterior vaginal wall.

What Is A Rectocele

Rectoceles are also sometimes called posterior vaginal wall prolapse. They are common, especially in women who have given birth. Mild rectoceles usually don’t require treatment unless symptomatic. More severe cases may necessitate surgical repair.

Symptoms Of A Rectocele

There are several possible symptoms associated with a rectocele, including:

◾️ Feeling of vaginal fullness or pressure

◾️ Sensation of sitting on a small ball

◾️ Difficulty evacuating bowels

◾️ Straining or splinting to empty bowels

◾️ Incomplete bowel emptying

◾️ Bulge of tissue extending from the vagina during bowel movement

◾️ Need to press against vagina to facilitate bowel movement

◾️ Fecal incontinence

◾️ Low back pain exacerbated by bowel movement

Causes Of A Rectocele

Some of the main causes and risk factors for developing a rectocele include:

◾️ Pregnancy and childbirth – especially multiple vaginal deliveries

◾️ Advancing age

◾️ Menopause

◾️ Chronic constipation and straining during bowel movements

◾️ Obesity

◾️ Prior hysterectomy

◾️ Genetics

◾️ Chronic cough

◾️ Heavy lifting

◾️ Prior pelvic surgery

How To Treat A Rectocele?

Mild cases of rectocele that aren’t causing bothersome symptoms usually don’t require treatment. For symptomatic rectoceles, treatment options include:

◾️ Kegel exercises to strengthen pelvic floor muscles

◾️ Use of a pessary device inserted into the vagina to support weakened tissue

◾️ Bowel movement retraining techniques

◾️ Topical estrogen cream to improve tissue integrity in some cases

◾️ Surgery such as posterior colporrhaphy to repair torn or stretched ligaments

For prolapse caused mainly by bowel straining, a procedure like STARR surgery may be warranted to remove the bulging rectal pocket through the anus.

Prevention Of A Rectocele

To help prevent occurrence of a rectocele, women can:

  • Perform Kegel exercises regularly to strengthen pelvic floor muscles
  • Maintain a healthy weight
  • Avoid constipation and pushing during bowel movements
  • Use proper techniques when lifting heavy objects
  • Stop smoking cigarettes
  • Limit coughing by managing respiratory conditions
  • Get pelvic floor therapy after pregnancy or pelvic surgery

Risks Of A Rectocele

Potential risks and complications associated with rectoceles include:

  • Worsening prolapse leading to bowel obstruction
  • Incontinence
  • Recurrence after surgical repair
  • Painful intercourse
  • Abscess or ulceration of rectocele tissue
  • Faecal incontinence

When To See A Doctor For A Rectocele?

See your doctor if you experience any of the following:

➜ A noticeable bulge protruding from the vagina

➜ Feeling of heaviness or pressure in the pelvis

➜ Problems emptying bowel

Lower back pain that worsens with bowel movements

➜ Discomfort during intercourse

Get evaluated promptly if you suddenly cannot pass stool or gas due to a vaginal obstruction. Seek emergency care for fever, bleeding or severe pain.


A rectocele is a rectal prolapse into the vagina occurring when supporting ligaments and muscles weaken. Symptoms include vaginal bulging, difficulty defecating and back pain. Rectoceles develop from childbirth, aging, constipation, and prior pelvic surgery.

Mild cases can be managed conservatively. Severe rectoceles may require surgical reinforcement and repair. Proper treatment can alleviate discomfort and improve quality of life.


1. Is a rectocele dangerous?

Most rectoceles do not pose any serious medical danger. However, very large prolapses can sometimes cause bowel obstruction or damage requiring emergency surgery.

2. Can a rectocele go away on its own?

Small rectoceles may spontaneously resolve, especially with pelvic floor exercises. But moderate or advanced prolapse usually requires some form of treatment to correct.

3. What activities should be avoided with a rectocele?

Avoid prolonged sitting, heavy lifting, straining during bowel movements, coughing, and high-impact exercise to prevent exacerbating a rectocele. Gentle exercise can help strengthen pelvic muscles.

4. Is a pessary uncomfortable?

Most women do not find pessaries bothersome once properly fitted and placed correctly. Regular monitoring and removal for cleaning is needed to prevent complications.

5. How long does rectocele surgery recovery take?

Recovery time depends on the type of surgery. Less invasive procedures have shorter recovery around 4-6 weeks. Open abdominal surgery may require a 6-12 week recovery period.

Dr. Jun Ren is a dedicated and experienced registered dietitian and nutritionist who is committed to helping people achieve their health goals through personalized nutrition plans. With a passion for promoting healthy eating habits and preventing chronic diseases, Dr. Ren has been able to assist numerous clients in improving their overall quality of life.

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