The more pregnancies a woman has the more likely she is to develop a rectocele, writes MARION KERR
BEING A little squeamish I usually avoid TV medical programmes. But the other evening in a friend’s house I watched a programme where the person had similar symptoms to ones I am experiencing.
I now think I might have something called a rectocele.
Can you tell me what this is?
A rectocele is when the wall of tissue separating the vagina from the back passage (rectum) becomes weakened.
This results in the wall of the rectum bulging into the vagina. Small rectoceles often produce no signs or symptoms.
Larger rectoceles can cause a range of symptoms including a noticeable bulge of tissue in the vagina, difficulty with bowel movements and a sensation of rectal fullness or pressure.
A sensation that the rectum has not completely emptied after a bowel movement may also occur.
Why do rectoceles develop?
The most common cause of a rectocele is pregnancy and childbirth.
The reason is that the tissues, muscles and ligaments that support the pelvic organs become stretched and weakened during pregnancy and labour.
The more pregnancies a woman has the more likely she is to develop a rectocele. Women who deliver their babies by Caesarean section are less likely to develop a rectocele compared with women who deliver vaginally.
Other factors which can influence the development of the condition include chronic constipation, chronic coughing, being overweight and repeated heavy lifting.
Additional factors include a genetic tendency towards the condition and having had a hysterectomy.
How can rectoceles be treated?
If you think you have symptoms of a rectocele, you really need to be examined by your doctor to confirm the diagnosis.
This usually involves a physical examination of the vagina and rectum which allows the doctor to check the size and location of the rectocele and to assess the strength of the pelvic muscles.
You may be referred on for further tests such as an MRI scan or an X-ray.
Treatment will depend on the severity of the problem.
Pelvic floor exercises (Kegels) can help strengthen weakened pelvic muscles in mild cases.
In more severe cases, a vaginal pessary – a small plastic or rubber ring inserted in the vagina – may be used to support the bulge.
Surgical repair of the weakened connective tissue and muscles that lie between the vagina and rectum may be recommended where the rectocele is large and causing troublesome symptoms.