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A layer of tissue separates the back wall of your vagina from your rectum (the last few inches of your large intestine).

If that tissue weakens or becomes damaged, the front wall of your rectum may bulge into your vagina. This is called rectocele.

Rectocele causes

The tissue between the rectum and the vagina, also called the rectovaginal septum, is part of the pelvic floor.

The pelvic floor is a group of muscles and other tissues that support several abdominal organs. Pelvic floor damage, particularly to the rectovaginal septum, is the main cause of rectocele. Pelvic floor damage leading to rectocele often results from the following:

  • Pregnancy and vaginal childbirth
  • Chronic constipation or difficulty passing stool
  • Prior hysterectomy
  • Obesity
  • Frequent heavy lifting or straining
  • Chronic or violent caughing

Rectocele symptoms

Speak with your primary care doctor or OB-GYN if you any of these symptoms and they don’t go away:

  • Feeling that something is bulging into your vagina
  • Feeling that something is about to fall out of your vagina
  • Constipation
  • Difficulty passing stool or urine
  • Need to press on the back wall of your vagina in order to have a bowel movement
  • Feeling that you have not completely emptied your bowel after a bowel movement

How can I get help for rectocele?

After examining you, your primary care doctor or OB-GYN may refer you to a colon and rectal surgeon or urogynecologic and pelvic reconstructive surgeon.

At Rush, you also have the option of contacting the Program for Abdominal and Pelvic Health, which is designed to address the full range of issues related to pelvic pain. The program has a coordinator who will help you navigate the multiple specialists you might need to see to find relief.

Care for rectocele at Rush

Nonsurgical treatments

To help manage your symptoms, your doctor at Rush may recommend one or more of the following:

  • High-fiber diet: Eating at least 25 grams of fiber every day can make your stools larger, softer and easier to pass. This means you won’t have to strain as much during bowel movements. The best way to add fiber to your diet is eating fiber-rich fruits and vegetables, such as raspberries, pears, apples, bananas, oranges, cooked artichoke, peas, broccoli and corn. Whole grains and legumes are also good sources of fiber. Learn more about eating for digestive health.
  • Fiber supplements: If you have trouble eating enough fiber, your doctor may also recommend fiber supplements.
  • Stool softeners: These help make your stools easier to pass, so you don’t have to strain as much.
  • Pessary: Doctors at Rush can fit you for this device, which you insert in your vagina to support your pelvic floor organs.
  • Physical therapy: Doctors and physical therapists at Rush can work with you to strengthen your pelvic floor muscles. This can help improve bothersome symptoms.
  • Avoiding strain: Heavy lifting, frequent coughing and other forms of strain can make symptoms worse. Your doctor can talk with you about strategies for avoiding them.

Rectocele surgery

Most people with rectocele do not need surgery. But if your rectocele is causing severe discomfort or significantly interfering with your quality of life, surgery may help.

If you are planning to become pregnant in the future, your doctor may recommend waiting to have surgery until you are done having children.

Skilled colon and rectal surgeons and urogynecologic and pelvic reconstructive surgeons at Rush offer several methods of putting the vagina back in place so that the rectum no longer bulges into it. They may operate through your vagina, anus or abdomen.

Why choose Rush for rectocele care

  • Minimally invasive expertise: Whenever possible, colon and rectal surgeons and urogynecologic and pelvic reconstructive surgeons at Rush use minimally invasive procedures that require only small incisions. These techniques, which include laparoscopy and robotic surgery, can lead to less scarring and pain, and faster recovery times.
  • Pioneering care for pelvic and abdominal health: More than a decade ago, Rush became the first academic medical center in Chicago to create a pelvic health program focused exclusively on providing care for patients with incontinence, vaginal pain, rectocele and other pelvic and abdominal conditions.

Departments and programs that treat this condition