A rectocele is a form of pelvic organ prolapse where the supportive tissue wall between the rectum and the vagina weakens, causing the rectum to bulge into the vaginal space. This anatomical change is a common condition, often resulting from factors like childbirth, chronic straining, and age-related tissue changes. While the rectocele itself does not generate an odor, its effect on normal bodily function can create circumstances that result in a distinctive smell.
The Mechanism Behind Rectocele-Related Odor
A rectocele can indirectly cause an odor due to the way it interferes with complete bowel emptying. The bulging pocket in the rectal wall can trap small amounts of fecal matter, preventing it from being fully evacuated during a bowel movement. This phenomenon is sometimes referred to as “stool trapping,” and the retained stool is the source of the potential odor.
When this residue is left behind, it can seep out later or cause accidental bowel leakage, known as fecal smearing, which can lead to hygiene issues. The presence of this trapped material creates an environment for the proliferation of odor-causing bacteria. Furthermore, the anatomical distortion can make effective perianal and vaginal cleansing more difficult.
Recognizing the Mechanical Symptoms of Rectocele
The symptoms of a rectocele are primarily mechanical and centered on bowel function. Many women report a persistent sensation of pressure or fullness in the vagina, sometimes describing it as feeling like something is “falling out”. This feeling can become more pronounced with prolonged standing or physical activity.
Difficulty passing a bowel movement, known as dyschezia, is a frequent complaint because the stool must push past the bulge. Patients often feel as though the rectum has not completely emptied. In some cases, to facilitate evacuation, a person may need to apply pressure to the back wall of the vagina or the perineum, a manual technique known as “splinting”.
Immediate Strategies for Symptom Management
Immediate symptom management focuses on optimizing bowel habits to prevent the stool trapping that can lead to odor and discomfort. Dietary modifications are foundational, including increasing the consumption of high-fiber foods to over 25 grams per day. Fiber, paired with adequate fluid intake, ensures stools are soft and bulky, making them easier to pass and less likely to get caught in the rectocele pocket.
Proper bowel habits also involve avoiding excessive straining during defecation, as this pressure can worsen the prolapse. Using a footstool to elevate the knees while sitting on the toilet can adjust the pelvic angle, which may help straighten the rectum and facilitate more complete emptying. Maintaining meticulous hygiene, especially after a bowel movement, is also helpful in managing any potential odor from residual smearing.
Professional Treatment Options for Rectocele
Professional management for rectocele begins with conservative, non-surgical approaches, particularly for mild cases. Pelvic floor muscle training, commonly known as Kegel exercises, is often prescribed to strengthen the supportive muscles of the pelvis. A specialized pelvic floor physical therapist can provide biofeedback and guidance to ensure these exercises are performed correctly, improving muscle tone and support.
Another common non-surgical option is the use of a vaginal pessary, a removable silicone device inserted into the vagina to provide structural support to the bulging tissues. Pessaries help reposition the pelvic organs and can significantly relieve symptoms. If conservative methods fail to provide sufficient relief, or if the rectocele is severe, a surgical repair may be recommended. The most common procedure is a posterior colporrhaphy, which involves reinforcing the weakened tissue wall between the rectum and vagina with sutures. This surgical correction is the definitive way to eliminate the underlying cause of both the mechanical symptoms and the associated odor.