Rectocele: Care Instructions

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Picture of normal female anatomy and rectocele

Overview

A rectocele occurs when the rectum moves from its normal position and presses against the back wall of the vagina. This is also called posterior vaginal wall prolapse.

A rectocele can happen when the muscles and tissues that hold the rectum in place get weak or damaged. This can be caused by pregnancy and childbirth, being overweight, or frequent constipation. Or the muscles and tissues may get weaker as you age.

A rectocele may not cause symptoms. Or, you may notice tissue pushing into your vagina when you strain or bear down during a bowel movement. You may feel pressure, have pain during sex, or have trouble passing stool.

A rectocele usually does not cause serious health problems. But if symptoms bother you, making lifestyle changes and doing exercises may help. Or your doctor may suggest a pessary. Surgery may also be an option.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

How can you care for yourself at home?

  • Avoid heavy lifting. It puts pressure on your pelvic muscles.
  • Try pelvic floor (Kegel) exercises, which tighten and strengthen pelvic muscles. (If doing these exercises causes pain, stop doing them and talk with your doctor.) To do Kegel exercises:
    • Squeeze your muscles as if you were trying not to pass gas. Or squeeze your muscles as if you were stopping the flow of urine. Your belly, legs, and buttocks shouldn't move.
    • Hold the squeeze for 3 seconds, then relax for 5 to 10 seconds.
    • Start with 3 seconds, then add 1 second each week until you are able to squeeze for 10 seconds.
    • Repeat the exercise 10 times a session. Do 3 to 8 sessions a day.
  • To ease pressure on your rectum and vagina, lie down and raise your legs by putting a pillow under your knees. You also can lie on your side and bring your knees up to your chest.
  • Ask your doctor about a vaginal pessary. It can placed in the vagina to help support the rectum. Your doctor can teach you how and when to remove, clean, and reinsert it.
  • Avoid constipation.
    • Include fruits, vegetables, beans, and whole grains in your diet each day. These foods are high in fiber.
    • Drink plenty of fluids. If you have kidney, heart, or liver disease and have to limit fluids, talk with your doctor before you increase the amount of fluids you drink.
    • Get some exercise every day. Build up slowly to 30 to 60 minutes a day on 5 or more days of the week.
    • Take a fiber supplement, such as Citrucel or Metamucil, every day if needed. Read and follow all instructions on the label.
    • Schedule time each day for a bowel movement. Having a daily routine may help. Take your time and do not strain when having your bowel movement.

When should you call for help?

Call your doctor now or seek immediate medical care if:

  • You have new or worse pain.
  • You have new or worse bleeding from the rectum.

Watch closely for changes in your health, and be sure to contact your doctor if:

  • You cannot pass stools or gas.
  • You do not get better as expected.

Where can you learn more?

Go to https://www.healthwise.net/patientEd

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The Health Encyclopedia contains general health information. Not all treatments or services described are covered benefits for Kaiser Permanente members or offered as services by Kaiser Permanente. For a list of covered benefits, please refer to your Evidence of Coverage or Summary Plan Description. For recommended treatments, please consult with your health care provider.