Rectocele

A rectocele is a bulge of the front end wall of the rectum into the vagina. The rectal wall may become thinned and weak, and it may balloon out into the vagina when y'all push down to have a bowel motion. Most rectoceles occur in women where the front wall of the rectum is up against the back wall of the vagina. This area is called the rectovaginal septum and may be a weak area in the female person anatomy. Other structures may also push button into the vagina. The bladder bulging into the vagina is called a cystocele. The rectum bulging into the vagina is termed a rectocele. And the minor intestines pushing down on the vagina from above may form an enterocele. Although uncommon, men may also develop a rectocele.

A rectocele may be present without any other abnormalities. In some cases, a rectocele may exist role of a more generalized weakness of pelvic back up and may be along with a cystocele, urethrocele, and enterocele, or with uterine or vaginal prolapse, rectal prolapse, and fecal or urinary incontinence.

What can cause a rectocele?

The underlying crusade of a rectocele is a weakening of the pelvic support structures and thinning of the rectovaginal septum. Certain factors may increase the risk of a woman developing a rectocele. These include birth trauma such as multiple, difficult or prolonged deliveries, the use of forceps or other assisted methods of delivery, perineal tears, or an episiotomy into the rectum or anal sphincter muscles. In addition, a history of constipation and straining with bowel movements, or hysterectomy may contribute to the development of a rectocele. Commonly, these problems develop with age but they may occasionally occur in younger women or in those that have not delivered children.

What are the symptoms of a rectocele?

Many women accept rectoceles but only a modest percentage of women accept symptoms related to the rectocele. Symptoms may be primarily vaginal 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 go irritated. Vaginal haemorrhage is occasionally seen if the vaginal lining of the rectocele is irritated, but other sources of the bleeding should be checked by your doctor. Rectal symptoms include constipation, specially hard evacuation with straining. Ofttimes this is associated with bulging in the vagina when straining to take a bowel movement. Some women find that pressing confronting the lower back wall of the vagina or along the rim of the vagina helps to empty the rectum. At times, in that location will be a rapid return of the urge to have a bowel move subsequently leaving the bath considering stool that was trapped in the rectocele may render to the lower rectum afterward standing up. A general feeling of pelvic pressure or discomfort is often present but this may exist due to a variety of problems.

How is a rectocele diagnosed?

Virtually rectoceles may be identified on a routine role test of the vagina and rectum. However, it may be difficult to assess the size and significance of the rectocele. A more than accur­ate method of assessing the rectocele is an x-ray study called a defecagram. This written report shows how large the rectocele is and if it empties with evacuation.

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How is a rectocele diagnosed?

Well-nigh rectoceles may be identified on a routine function examination of the vagina and rectum. Nonetheless, it may exist difficult to assess the size and significance of the rectocele. A more accur­ate method of assessing the rectocele is an x-ray study called a defecagram. This study shows how large the rectocele is and if it empties with evacuation.

When should a rectocele exist treated?

You should consider having your rectocele treated when it causes significant symptoms. It takes an experienced dr. to help yous determine whether your symptoms are caused by a rectocele. If at that place are multiple abnormalities present, it may be best to address them all at once as this volition result in the best chance for improvement.

What treatment is bachelor for a rectocele?

Rectoceles that are not causing symptoms practise not need to be treated. In general, you should avoid constipation by eating a high fiber diet and drinking plenty of fluids.

Medical Treatment

A bowel management programme is the all-time start footstep. This includes a diet loftier in cobweb and 6 to 8 spectacles of fluids each day. Fiber acts like a sponge. It soaks upward fluid so that less is removed as the stool travels effectually the colon. The stools volition be larger, softer and easier to pass. You may wish to add together a cobweb supplement and/or a stool softener to this regimen to improve stool consistency. Nigh fiber supplements are made of psyllium, a seed production, or of a hydrophilic colloid (gel) that absorbs water. Most stool softeners are composed of docusate. This helps to polish and lubricate the stool. Agile laxatives are all-time avoided in most cases.

Avoid prolonged straining. If you lot cannot completely empty, get up and return afterward. Holding force per unit area with a finger to back up the rectocele and encourage the stool to become in the right direction is often helpful. This may be accomplished by pressing confronting the lower back wall of the vagina or along the posterior rim of the vagina. Avert placing a finger inside the anus to pull the stool out as this may crusade harm. A pessary may be used to back up the pelvic organs. It is a ring that is inserted into the vagina and must be individually fit to each woman.

Surgical Handling

If symptoms persist even with medical therapy, and so surgical repair may be indicated. There are several surgical techniques used to repair a rectocele. A rectocele repair may be performed through the anus, through the vagina, through the perineum between the anus and vagina, or from to a higher place through the belly. When there is extensive pelvic relaxation and prolapse, the best approach may be a combined repair.

Who should care for me for this trouble?

Both colorectal surgeons and gynecologists are trained to deal with these bug. If the symptoms are entirely vaginal, then it is appropriate for your gynecologist to address the problem. If your symptoms are rectal, so a colorectal surgeon should be involved. If there is any question, seek opinions from physicians of both specialties.