A rectocele is a common condition where the rectum bulges into the vagina, a form of pelvic organ prolapse. While not life-threatening, it can cause discomfort. Understanding its management improves quality of life. This article provides guidance on living with a rectocele, exploring strategies for symptom relief and well-being.
Understanding a Rectocele
A rectocele develops when the supportive tissue wall between the rectum and vagina weakens, allowing the rectum to protrude into the vaginal space. Symptoms can occur, though smaller rectoceles may cause no noticeable issues.
Symptoms often include a sensation of pressure or fullness in the vagina or rectum. Some women describe feeling as though something is “falling out” of the vagina, especially after prolonged standing.
The primary impact often centers around bowel function. Individuals may experience difficulty having a complete bowel movement, a feeling that the rectum has not fully emptied, or the need to strain excessively.
Stool can sometimes become trapped in the bulge, requiring manual pressure (splinting) on the vaginal wall to facilitate evacuation. Other symptoms include discomfort during sexual intercourse or a visible soft bulge of tissue in the vagina.
Daily Management Strategies
Managing a rectocele often begins with lifestyle adjustments to reduce pelvic floor strain and promote healthy bowel habits. Dietary modifications are foundational, emphasizing a high-fiber diet and adequate hydration to prevent constipation and soften stool.
Proper toileting posture can significantly ease bowel movements and minimize straining. Elevating the feet on a small stool while sitting on the toilet helps align the rectum, facilitating easier stool passage. Avoid prolonged sitting and resist forceful straining, as this puts excessive pressure on the pelvic floor.
Allow the body to naturally pass stool without undue effort. Other lifestyle modifications include avoiding heavy lifting, which increases intra-abdominal pressure and can strain the pelvic floor. Managing chronic coughing, such as from allergies, is beneficial, as persistent coughing stresses the pelvic region.
Maintaining a healthy body weight reduces overall pressure on the pelvic floor muscles. Learning gentle techniques, such as applying external pressure to the perineum during a bowel movement, can assist in emptying without excessive pushing.
Non-Surgical Support Options
When daily management strategies are insufficient, non-surgical medical interventions offer further support. Pelvic floor physical therapy is a widely recommended first-line treatment that strengthens and coordinates pelvic floor muscles.
A specialized physical therapist guides individuals through exercises to improve muscle tone, support pelvic organs, and enhance bowel function. This often includes teaching proper techniques for muscle contraction and relaxation, along with biofeedback for better muscle control.
Pessaries represent another non-surgical option, providing mechanical support to prolapsed organs. A pessary is a removable silicone device inserted into the vagina to hold pelvic organs in their correct anatomical position.
These devices come in various shapes and sizes, and a healthcare provider can fit the most appropriate type to alleviate symptoms like pressure or a bulging sensation. Pessaries can effectively manage symptoms and improve comfort, especially for those who wish to avoid surgery or for whom surgery is not suitable.
Considering Surgical Solutions
For individuals whose symptoms significantly affect quality of life despite conservative and non-surgical approaches, surgical intervention may be considered. Surgery for a rectocele aims to repair the weakened tissue between the rectum and the vagina, restoring anatomy and improving function.
The decision to pursue surgery is made after evaluating symptoms, prolapse extent, and impact on daily activities.
Several surgical techniques are available, all designed to reinforce the rectovaginal septum, the tissue wall separating the rectum from the vagina. Procedures often involve stitching the weakened tissue together, sometimes with added mesh material for extra support.
The goal is to reduce the bulge and improve bowel evacuation. Recovery after rectocele surgery varies, generally involving rest and avoiding strenuous activities to allow tissues to heal.
While surgery can offer significant symptom improvement, discussing potential risks, such as infection or recurrence, with a healthcare provider is important.