Bulging of the front wall of the rectum into the vagina. Rectocele is due to weakening of the pelvic support structures and thinning of the rectovaginal septum (the tissues separating the rectum from the vagina). Also called a proctocele.

Risk factors for a rectocele include a history of multiple, difficult or prolonged deliveries, forceps or other assisted methods of delivery, perineal tears, an episiotomy into the rectum or anal sphincter muscles, hysterectomy, and constipation and straining with bowel movements.

Rectoceles may cause no symptoms. If they do, the symptoms may be vaginal and/or rectal. Vaginal symptoms include vaginal bulging, the sensation of a mass in the vagina, pain with intercourse or even something hanging out of the vagina that may become irritated. Rectal symptoms include constipation difficult defecation, and unusually frequent urge to have a bowel movement.

A rectocele should only be treated if it causes significant symptoms. The treatment may be medical or surgical. Medical options include a high fiber diet and ample fluids (to avoid constipation), stool softeners, and a pessary inserted into the vagina to support the pelvic organs. Surgery is meant to repair the rectocele.

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