Rectocele

Specialty of Surgery

What is rectocele?
Rectocele, also known as posterior vaginal prolapse, is a condition in which the tissue wall between the rectum and vagina weakens. This allows the vaginal wall to bulge. Childbirth and processes that put pressure on pelvic tissues can lead to rectocele. Self-care measures are often very effective but severe rectocele may require surgical repair.

What are the symptoms of rectocele?
A woman may notice pressure within the vagina, or that her bowels do not feel empty after having used the bathroom. In moderate cases, when trying to push the stool out through the anus may push it into the rectocele instead. This can cause pain and discomfort and creates a higher chance of having constipation. It could also lead to pain during sexual intercourse. More severe cases include vaginal bleeding and sometimes the rectocele bulge may prolapse through the vagina mouth or through the anus. Most of the time, many women have a rectocele but do not notice all of the symptoms.

What causes rectocele?
The commonest cause of rectocele is childbirth, especially if the baby is heavy, or if the birth happens quickly. The muscles, ligaments and tissues in the vagina become stretched and weakened during pregnancy, labour and delivery. If a woman has had more than one vaginal birth she is at a higher risk of developing rectocele. Women who have never given birth can also develop a posterior vaginal prolapse. Rectocele occurs as a result from pressure on the pelvic floor. Increased pelvic floor pressure can be caused by constipation or straining with bowel movements, chronic coughing, repeated heavy lifting or obesity.

What are the risk factors of rectocele?
The following factors may increase the risk of rectocele:

  • Genetics – some women are born with weaker connective tissues in the pelvic area.
  • Childbirth – delivering more than one child creates a higher risk of having rectocele.
  • Ageing – growing older means naturally losing muscle mass and elasticity.
  • Being overweight – carrying extra body weight causes stress on the pelvic floor tissues.

How can you prevent rectocele?
To reduce the risk of worsening rectocele, a woman can:

  • Follow Kegel exercises on a regular basis – these movements can help to strengthen pelvic floor muscles.
  • Treat constipation – by eating high-fibre foods and drinking plenty of water.
  • Avoid heavy lifting.
  • Treat chronic coughing.
  • Maintain a healthy weight.

When should you see a doctor?


Rectocele is a common condition in both women who have had children and those who have not. It is recommended to see a specialist if suffering from chronic constipation and if there is a bulge of tissue that protrudes through the vaginal opening. 

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