Posterior Vaginal Prolapse (Rectocele)

A posterior vaginal prolapse, also known as a rectocele, occurs when the wall of tissue that separates the vagina and rectum weakens, allowing the rectum to bulge into the vagina. This condition can cause discomfort, difficulty with bowel movements, and other symptoms.

Causes and Risk Factors

The causes and risk factors for posterior vaginal prolapse include:

• Childbirth: Vaginal delivery can weaken the muscles and tissues that support the vagina and rectum.
• Aging: Weakening of the muscles and tissues with age can contribute to the development of a rectocele.
• Constipation: Straining during bowel movements can put pressure on the wall between the vagina and rectum, leading to weakness and bulging.
• Chronic coughing: Coughing can increase pressure on the pelvic floor muscles, contributing to prolapse.
• Obesity: Excess weight can put additional strain on the pelvic floor muscles.
• Hysterectomy: Removal of the uterus can lead to a weakening of the support structures for the vagina and rectum.

Symptoms

The symptoms of posterior vaginal prolapse may include:

• A bulge or lump in the vagina
• Difficulty with bowel movements, such as straining or feeling like the rectum is not completely empty
• Pain or discomfort during sex
• Feeling of pressure or heaviness in the vagina
• Leakage of stool or gas during bowel movements

Diagnosis

Diagnosis of posterior vaginal prolapse typically involves a physical examination by a healthcare provider. The provider may:

• Perform a pelvic exam to assess the strength and integrity of the vaginal walls
• Use a speculum to visualize the vagina and rectum
• Check for any other signs of prolapse or pelvic floor weakness

Treatment Options

Treatment options for posterior vaginal prolapse may include:

• Kegel exercises: Strengthening the pelvic floor muscles through Kegel exercises can help improve symptoms.
• Biofeedback therapy: This type of therapy can help individuals become more aware of their pelvic floor muscles and learn to control them.
• Pessary: A pessary is a device that is inserted into the vagina to provide support for the vaginal walls.
• Surgery: In some cases, surgery may be necessary to repair the weakened tissue and restore support to the vagina and rectum.

Prevention

To help prevent posterior vaginal prolapse, individuals can:

• Practice Kegel exercises regularly
• Maintain a healthy weight
• Avoid constipation by eating a high-fiber diet and staying hydrated
• Avoid heavy lifting or straining