What is a rectocele?

A rectocele is a type of pelvic organ prolapse where the lower part of the rectum bulges into the back wall of the vagina. This occurs due to weakness in the tissue separating the rectum and vagina.

What causes a rectocele?

• Childbirth – Tearing or stretching of the supporting tissues during vaginal delivery is the most common cause

• Chronic straining – Excessive straining during bowel movements can weaken the pelvic floor and contribute to rectocele development

• Pelvic floor dysfunction – A rectocele may be associated with other conditions such as internal rectal prolapse (intussusception), enteroceles, and anal incontinence

Symptoms of rectocele

If you have a rectocele, you may experience:

• A bulge in the back of the vagina, which may become more noticeable when straining

• Difficulty emptying the bowel, as stool can become trapped inside the bulge

• The need to press on the vaginal wall or perineum (area between the anus and vagina) to help empty the bowel

• A sensation of incomplete emptying, leading to stool leakage after using the toilet

• Some women find that leaning back on the toilet helps with bowel emptying

How is a rectocele diagnosed?

To confirm that your bowel symptoms are caused by a rectocele, your doctor may recommend:

• Flexible sigmoidoscopy or colonoscopy – To rule out other bowel conditions

• Video proctogram – A dynamic imaging test that confirms the presence of a rectocele and whether stool is becoming trapped inside it. It can also detect internal rectal prolapse (intussusception) or an enterocele, which may require treatment at the same time

• Anorectal physiology testing – To assess sphincter muscle function

• Endoanal ultrasound scan – To check for muscle damage in the anal region

Treatment for rectocele

Non-surgical management

If your symptoms are mild, surgery may not be necessary. Lifestyle and dietary changes can help prevent the rectocele from worsening:

• Keeping stools soft with a high-fibre diet and adequate hydration

• Avoiding excessive straining during bowel movements

• Using glycerine suppositories to aid emptying

Surgical treatment

If a rectocele is causing significant bowel emptying issues, a surgical repair may be recommended.

At the Midlands Bowel Clinic, the most common procedure performed is a transanal rectocele repair. If other pelvic floor weaknesses are identified, such as an internal prolapse (intussusception) or an enterocele, a ventral mesh rectopexy may be recommended instead.

Why choose the Midlands Bowel Clinic?

• Expert colorectal and pelvic floor specialists experienced in rectocele repair

• Advanced diagnostic testing, including videoproctogram and anorectal physiology assessment

• Minimally invasive treatment options for faster recovery

• Personalised care plans tailored to your individual symptoms and needs

Contact us

If you are experiencing bowel emptying difficulties, vaginal bulging, or stool leakage, contact us today for expert diagnosis and treatment options.