Rectocele is a weakness in the tissue between the rectum and the vagina. It causes the front wall of the rectum to bulge into the vagina.

It is a common finding in women and is usually caused by weakening of the tissue between the rectum and vagina. It is usually related to childbirth and vaginal deliveries. A vast majority of women with a rectocele are asymptomatic. In some it may cause a difficulty in passing the bowel movement especially when the stool is hard. Application of pressure either in the space between the anal opening and the vagina or on the back wall of the vagina helps initiate the bowel movement.

It is diagnosed by clinical examination. The size and degree of emptying of the rectocele is assessed by a special barium test called a defecogram.

The medical management consists of ensuring a soft bowel movement by using fiber and stool softeners. In women with symptomatic, poorly emptying rectoceles, surgery would be necessary. There are several surgical approaches including an approach from the rectal or vaginal aspect. The status of the other pelvic organs, namely the uterus and the bladder, will determine the exact nature of treatment and the surgical approach.

Read more about rectocele at the American Society of Colon & Rectal Surgeons website.