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Pelvic floor exercises may help to manage rectocoele symptoms.

Pelvic floor exercises may help to manage rectocoele symptoms.
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Rectocoele

A rectocoele occurs when the rectum (the lower part of the large bowel) bulges into the back vaginal wall, due to weakening of the supporting tissue. It is also known as a posterior prolapse. This page guides you to appropriate care and treatment that can help you manage this condition.

Rectocoele causes

Anything that weakens the muscles around the vagina or rectum can cause a rectocoele.

So women who are pregnant, who have given birth or who have passed menopause are more likely than others to have a rectocoele.

A rectocoele can also be caused by:

  • chronic constipation
  • chronic cough
  • being overweight or obese
  • repeated heavy lifting.

Rectocoele symptoms

It is possible to have a rectocoele without noticing any problems. If you do have symptoms, they can include:

  • a lump or bulge in your vagina
  • needing to press your fingers on the vaginal bulge (‘splinting’) to help push the stool out when having a bowel movement
  • constipation or difficulty in emptying the bowels completely
  • pressure, heaviness or fullness in the pelvis that may feel like ‘bearing down’, or as though something is ‘falling out’
  • ‘looseness’ in the vagina.

The symptoms may get worse after a long day standing.

For some people, the symptoms of a rectocoele are mild, but for others, they have a big impact on their life.

Rectocoele diagnosis

See your doctor if you have any symptoms. Your doctor will probably ask you about your symptoms and how they affect your daily life. Your doctor might conduct an internal pelvic examination, and might recommend an ultrasound. You might be referred to a specialist.

Rectocoele treatment and management

Treatment depends on the severity of the rectocoele.

If you have few symptoms, you might be encouraged to do pelvic floor exercises.

You might be able to reduce your symptoms by being active, drinking plenty of water and consuming enough fibre, which can help prevent constipation.

Your doctor might also recommend using a pessary, which is a plastic device inserted into the vagina to provide support.

Surgery might be recommended if your symptoms are troublesome. Surgical treatments include repair of the weakened tissues of the vagina, or the use of a mesh patch to support the wall between the rectum and vagina.

Last reviewed: August 2016

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