Rectocele or Posterior Prolapse

What Is Rectocele Or Posterior Prolapse?

Rectocele also known by the name of Posterior Prolapse is a medical condition in which the fascia which separates the rectum from the vagina becomes weak resulting in prolapse of the vaginal wall. The name Rectocele comes from the fact that usually it is the front wall of the rectum which bulges into the vagina. Childbirth is one of the major cause of Rectocele as it causes undue pressure on the fascia which connects the rectum to the vagina leading to a prolapse. If the prolapse is mild then it basically remains asymptomatic, but if the prolapse is relatively large then it may result in a large noticeable bulge through the opening of the vagina which may cause some discomfort to the affected individual even though it is not painful in any way. In severe cases of Rectocele or Posterior Prolapse, a surgery may be required whereas mild cases of Rectocele do not require any specific treatment and self care measures are usually enough to cope up with this condition.

Rectocele Or Posterior Prolapse

What Are The Causes Of Rectocele Or Posterior Prolapse?

Rectocele or Posterior Prolapse can be caused due to the following:

Rectocele Or Posterior Prolapse Caused Due To Posture: If a woman has a habit of walking straight and upright, then it causes extra pressure on the pelvic floor muscles which may lead to a Rectocele Posterior Prolapse.

Rectocele or Posterior Prolapse Caused Due To Increased Pressure on the Pelvic Floor Muscles: Some of the activities which may lead to excessive pressure on the muscles of the pelvic floor are:

  • Chronic constipation
  • Severe straining while passing bowels
  • Chronic cough
  • Frequent heavy lifting
  • Obesity
  • Pregnancy.

What Are Some Of The Risk Factors For Rectocele Or Posterior Prolapse?

The following are the factors which predisposes an individual to Rectocele:

Genetic Factors & Rectocele: Some females by birth have weak pelvic floor muscles and connective tissues in the pelvic region thus predisposing them to Rectocele than females who are born with stronger pelvic region.

Childbirth & Rectocele: If a female delivers multiple children vaginally then this significantly weakens the pelvic floor muscles and this increases the risk for a Rectocele. In case if a female has had perineal tears or has had episiotomies during childbirth then it also increases the risk for Rectocele.

Rectocele Or Posterior Prolapse Due To Aging: As a woman ages, due to natural wear and tear the muscles of the pelvic floor weakens with natural loss of muscle mass, elasticity, and nerve function predisposing the woman to Rectocele.

Obesity Can Lead To Rectocele: An obese female is at higher risk of developing a Rectocele as the increased abdominal weight puts excessive pressure on the pelvic region and in turn weakens the pelvic floor muscles leading to Rectocele or Posterior Prolapse.

What Are The Symptoms Of Rectocele Or Posterior Prolapse?

Mild cases of Rectocele or Posterior Prolapse are asymptomatic and do not produce any symptoms. In case of severe forms of Rectocele or Posterior Prolapse the following symptoms may be observed:

  • Soft bulge of tissue in the vagina which may protrude through the opening of the vagina
  • Problems with bowel movements requiring the female to press on the bulge in order to have a bowel movement
  • Feeling of pressure in the rectal area
  • Sensation of incomplete emptying of the rectal area even after a bowel movement
  • Problems with sexual activity.

How Is Rectocele Or Posterior Prolapse Diagnosed?

Majority of the cases of Rectocele or Posterior Prolapse is diagnosed by a detailed physical examination of the rectum and the vagina. On examination of the pelvis, the treating physician will ask the female to sit as if she is having a bowel movement and then observe if there is protrusion through the vaginal opening. Once there is protrusion, the physician will note the exact location and size of the bulge. Additionally, the physician may ask the female to contract the pelvic floor muscles in order to assess the strength of the pelvic floor muscles which if weak may indicate Rectocele or Posterior Prolapse. The physician will also inquire as to the extent of the bulge and how has it impacted the quality of life of the female.

Usually a physical examination of the pelvic area is enough to identify a Rectocele but in some cases radiographic studies may be ordered like MRI scan or an ex-ray to look at the exact size of the bulge and the precise location of it so that the physician can formulate a treatment plan for it.

What Are Treatments For Rectocele Or Posterior Prolapse?

The treatment for Rectocele or Posterior Prolapse depends on the severity of the condition. The following steps are taken for treatment of Rectocele.

Simple Observation: This method is used when the bulge causes little to no symptoms and no specific treatment is required. Simple self-care techniques like performing Kegel exercises to strengthen the pelvic floor muscles are sufficient enough to control the symptoms.

Pessary Insertion To Treat Rectocele Or Posterior Prolapse: Another form of treatment is insertion of a pessary into the vagina in order to support the weak pelvic tissues. There are many types of pessaries available in the market which can even be removed and cleaned and then inserted again.

Surgery For Rectocele Or Posterior Prolapse: If the female has a significant enough prolapse that it is causing significant discomfort to the individual then a surgery may be required for correction of Rectocele. The surgical procedure will correct the protruding bulge but it may not normalize the bowel dysfunction caused due to Rectocele. The surgical procedure consists of removal of excess tissue that causes the protrusion. Normally, a vaginal approach is taken for the procedure. In some cases, a mesh may be required to support the fascia between the rectum and the vagina. In case if a female with Rectocele or Posterior Prolapse is considering becoming pregnant then the physician may delay the surgery until after the female is through with the pregnancy. Until then, a pessary may be inserted for symptom control and lessening the discomfort.

How Can Rectocele Be Prevented Or Posterior Prolapse?

If a female has risk factors for developing Rectocele or Posterior Prolapse but still has not developed Rectocele then one the following steps may help in preventing the development of it:

  • Kegel Exercises To Prevent Rectocele or Posterior Prolapse: Performing regular Kegel exercises to strengthen the pelvic floor muscles, especially after delivering a child can be very helpful.
  • Diet To Prevent Rectocele or Posterior Prolapse: Avoid constipation by consuming high fiber diet and consuming plenty of liquids
  • Try and avoid heavy lifting and other strenuous activities which may put pressure on the pelvic muscles.
  • Coughing: In case of an individual has frequent coughs then getting treated promptly is the way to go.
  • Avoid smoking
  • Maintain adequate weight, especially after childbirth.

Written, Edited or Reviewed By:


Last Modified On: September 21, 2016

Pain Assist Inc.

Pramod Kerkar
  Note: Information provided is not a substitute for physician, hospital or any form of medical care. Examination and Investigation is necessary for correct diagnosis.

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