Rectocele (Posterior Vaginal prolapse) & Incontinence
As you get older, it’s common to have problems with your digestive system. Although you shouldn’t ignore issues like constipation or urgent bowel movements, you should know that you’re not alone. Pelvic organ prolapse is a likely cause of chronic incontinence. Women are more likely to have different types of pelvic organ prolapse, and it’s important to get medical attention when you notice the symptoms. If you’re dealing with rectocele incontinence, there are a few treatments you should know about.
Pelvic Prolapse Basics
The pelvis holds organs for different body systems. The muscles and connective tissues have to keep those organs in the right position, and they may not be able to do so for everyone. When the organs lose their position and drop down, it is called a pelvic organ prolapse. Patients are more likely to be women, as a result of bearing children, menopause or other causes. A variety of organs may be involved in the prolapse, commonly the bladder, uterus, vagina or rectum.
Prolapse and Bowel Incontinence
Pelvic organ prolapse leads to a variety of symptoms, and incontinence is a common one for rectum prolapse and rectocele. When the rectum bulges into the vagina or anus, it can create spaces in the rectum that make it difficult to have a normal bowel movement. If feces get caught in these spaces, patients may struggle with constipation. People dealing with rectocele and rectal prolapse and incontinence are more likely to use over-the-counter laxatives as a result. The weakening of the muscles controlling the anus can also cause frequent diarrhea or bowel incontinence. For many patients, it might feel like a hemorrhoid, with pain, itching and occasional bleeding.
Rectal Prolapse vs. Rectocele
Many people often confuse rectal prolapse and rectocele to be the same thing. Rectocele also called posterior vaginal wall prolapse is a type of pelvic organ prolapse in which the tissues between the vagina and rectum is weakened. Those tissue will push into the vaginal wall causing it to prolapse through the vaginal opening. Rectal prolapse on the other hand is when the rectum prolapses into the anal opening. Prolapse symptoms depends on the severity of the prolapse and its location. People who suffer from rectocele may notice symptoms including:
- Pain during intercourse
- Feeling the vaginal wall sag during a bowel movement
- Feelings of looseness or fullness in the vagina
Treatment for rectocele is similar to other treatments for pelvic organ prolapse.
Common Treatments for Rectocele (Posterior Vaginal Wall Prolapse)
When you first ask your doctor about symptoms, you may have a few different tests to identify the cause of the problems. If your symptoms seem consistent with rectal prolapse, you may need to have a colonoscopy or other procedures to assess the condition of your rectum. For treatment, doctors usually recommend trying non-surgical methods as a way to manage your symptoms. These include:
- Pelvic floor therapy to strengthen your muscles
- Pessaries to keep the organs in place
- Changes to diet and exercise, to help avoid aggravating your symptoms
You may need several months to determine if these treatments can manage your symptoms.
If your symptoms are severe, or if you haven’t been able to get relief through non-surgical methods, your doctor may recommend surgery to correct the prolapse. The type of surgery depends on the location and other factors related to the prolapse. In most cases, you’ll have a relatively short procedure with small incisions through your abdomen, vaginal wall or rectum. The surgery fixes the prolapse and may provide additional support to help keep it from happening again. Prolapse can re-occur in about two in five patients who have surgery for rectal prolapse. Your surgeon will recommend lifestyle changes to minimize your risk.
How to Manage Rectocele
Whether you are considering surgery for rectocele or not, there are a few things you should think about incorporating into your daily routine. These tips can make bowel movements more comfortable and help to keep the prolapse from getting worse:
- Consuming higher amounts of dietary fiber
- Drinking plenty of water each day, at least 64 ounces or more
- Allowing gravity to do most of the work during a bowel movement
- Performing Kegels or other pelvic floor strengthening exercises
With other treatments as prescribed by your doctor, you may notice significant relief in your daily symptoms.
Importance of Seeking Treatment for Prolapse
For your comfort and health, it’s important to speak to a doctor you can trust about your concerns. Many people avoid seeking treatment for rectocele, out of embarrassment or a hope that it will get better over time. For adults, this is usually not the case. The problems that cause the prolapse probably won’t improve without treatment. Symptoms can get worse, and they often do without attention. Investing the time to get assistance can make you feel better and help you reduce the symptoms, possibly even eliminating them entirely.
Treatment for rectocele is often a team effort, with you, your doctor and other specialists helping you to feel better. In many cases, your doctor might recommend use of tools that help to position your pelvic organs correctly. FemiCushion is a non-invasive device that could be a good choice. Browse our frequently asked questions, then visit our shop to learn more about our products. If you have additional questions about our products, contact us today.
Supervising Doctor of This Article
Koichi Nagao, MD PhD
Professor, Department of Urology, Toho University Faculty of Medicine
Director of Urinary tract reconstruction center, Toho University Omori Medical Center
Director of Reproduction Center, Toho University Omori Medical Center
Professor Nagao specializes in plastic surgery in the field of reproductive medicine. He completed eight years of plastic surgery training at Showa University before majoring in urology at Toho University. With his meticulous surgical techniques and careful examinations that combines urology and plastic surgery, Professor Nagao became a Board Certified Specialist with multiple associations including the Japanese Urological Association, the Japan Society for Reproductive Medicine, and the Japanese Society for Sexual Medicine.