Do you also have this discomfort? Let's talk about Rectocele!

Do you sometimes feel a heaviness or fullness in your vagina? Or do you feel like you have difficulty passing stools or that you haven't completely passed out? These can be symptoms of a condition that many women experience at times, but are a little reluctant to talk about. Today we are talking about a condition called Rectocele, which causes such discomfort.

What is Rectocele? Let's find out simply!

Simply put, a rectocele is a condition where the tissue between your rectum and vagina weakens, causing the rectum to protrude into the back wall of your vagina. This is sometimes called a posterior vaginal wall prolapse. Think about it, there is a strong muscular system that helps keep the organs inside your abdomen, like your uterus, bladder, and rectum, in their proper place. We call this the pelvic floor . It's like the floor of a house. So, when these pelvic floor muscles weaken, these organs start to sag and move around.

Rectocele is a type of pelvic organ prolapse (POP) . It often occurs along with other pelvic organ prolapse conditions, such as uterine prolapse or fallen bladder. It is not life-threatening, but it can be a little disruptive to your daily life, or quality of life. The good news is that there are several treatments available .

What are the symptoms of a rectocele?

Not everyone with a rectocele will experience major symptoms, but some people may experience:

• You may feel a soft bulge in the back wall of your vagina. Sometimes you can feel this yourself.
• Even after defecating, you feel like your rectum hasn't completely emptied. It feels like there's still a little more.
• To pass stool, you have to squeeze the dilation in your vagina with your fingers. This is called 'splinting' . It's a little uncomfortable, but some people have to do it.
• Fecal incontinence is the involuntary leakage of stool. This can be very uncomfortable.
• Feeling of looseness and lack of tightness in the vaginal muscles.
• Pain during sexual intercourse (dyspareunia).
• A feeling of pressure or fullness in the rectum or vagina, as if something is stuck.
• Fecal urgency is the sudden need to defecate several times a day.

These symptoms are usually more of an inconvenience than a pain. However, if you think you have one, it's best to talk to your gynecologist or primary care provider.

Why does Rectocele occur? What are the causes?

The main reason for a rectocele is, as I mentioned before, the weakening of your pelvic floor muscles. There are several factors that can affect this. See if any of these apply to you:

• Frequent pregnancies and childbirths: Having many children, especially more than five (high parity), can weaken the pelvic floor muscles over time.
• Vaginal delivery: During normal childbirth, there is a risk of damage or weakening of the pelvic floor. This risk is especially high if the baby was delivered using forceps, a vacuum delivery, a vaginal tear, or an episiotomy, which is a small incision made in the vagina to make it larger.
• Aging: Like all muscles in our bodies, the pelvic floor weakens over time. Especially with hormonal changes after menopause, the muscles in this area can become less firm.
• Obesity: As body weight increases, it simply puts additional pressure on the pelvic floor muscles.
• Chronic constipation: Constant straining to have a bowel movement puts a lot of pressure on the pelvic floor muscles. Think of it like lifting a heavy weight all the time.

Important: In addition to this, a chronic cough, conditions like bronchitis, or frequent heavy lifting can also affect this.

How do doctors recognize this?

Gynecologists can usually diagnose this condition by asking about your symptoms and performing a pelvic exam . They can also check for any prolapse inside the vagina and the strength of your pelvic floor muscles.

Imagine, the doctor tells you to tighten and relax your pelvic floor muscles as if you were holding back urine. Or, he tells you to apply pressure to your stomach as if you were having a bowel movement. If you do this, you'll see the prolapse clearly.

After this pelvic examination, the doctor may use a grading or staging scale to classify the rectocele, depending on its severity, that is, how far it has progressed.

In rare cases, you may be asked to have a transvaginal ultrasound to see if your small intestine is also prolapsed (enterocele). You may also be asked to have a special X-ray or an MRI called defecography , which shows changes in the rectum during bowel movements. This can help determine the severity of the rectocele.

How is a Rectocele treated?

Doctors usually first try nonsurgical management , especially if you have a small, mild rectocele. However, if it's a little lower and more severe, your doctor may recommend surgery.

Nonsurgical management

These methods include:

• Pelvic floor exercises: These are also called Kegel exercises . These exercises can strengthen the muscles of the pelvic floor. A physical therapist who specializes in pelvic floor therapy can guide you well in this regard.
• Preventing constipation and bloating: Your doctor will tell you to eat more fiber-rich foods, drink plenty of water, and may also tell you to use a stool softener.
• Vaginal pessary: ​​This is a ring-like device that is inserted into the vagina and used to support the lower genitals. It can be removed at any time.

Surgery

If the simple treatments mentioned above don't relieve your symptoms, the next option is surgery. You and your doctor will discuss the following factors to decide which surgery is best for you:

• Your age and general health.
• How terrible your humiliation is.
• Are you expecting more children?
• Whether you want to have sex through the vagina (because some surgeries for this kind of degradation, for example, a surgery called colpocleisis, close the vagina).

A common surgery for rectocele is a posterior colporrhaphy . In this, the surgeon removes damaged tissue that does not support the pelvic organs and sutures healthy tissue together. This provides additional strength.

Most of the time, rectocele surgery is done through the vagina, so there are no external scars.

When should I see a doctor?

If your symptoms are getting worse, or if you don't seem to be getting better with the treatments you've been given, be sure to tell your doctor.

It may also be helpful for you to ask your doctor some questions like these:

• What changes can I make to my lifestyle to reduce my symptoms?
• What should I do to prevent my rectocele from getting worse?
• What can I do to prevent other types of pelvic organ prolapse?
• Would you recommend surgery? If so, what are the risks?
• What is the success rate of the type of surgery you recommend?
• Will these treatments have any effect on my sex life or my chances of getting pregnant again?

Ask these questions and clarify everything that is on your mind.

Can a rectocele be prevented?

It is not always possible to prevent a rectocele or other pelvic organ prolapse. However, there are many things you can do to help keep your pelvic floor strong. Many of the same management strategies for someone with a rectocele can also be used to reduce this risk. For example, doing pelvic floor exercises regularly and avoiding constipation .

What should I expect if this is the case?

Your outcome will depend on your symptoms and the severity of the prolapse. Many people who have rectocele surgery experience relief from their symptoms after surgery.

Talk to your doctor to find out how your condition will respond to the treatment recommended for you.

What happens if a rectocele is left untreated?

If left untreated and without lifestyle changes, a rectocele can get worse. Over time, your symptoms may worsen and affect your daily life even more.

Can stool get stuck inside a rectocele?

Yes. If the prolapse is severe, stool can get stuck in a pocket like the one formed by the rectocele. Then the stool won't come out easily.

Think about it this way: Sometimes you may have to 'splint' to pass stool, which means you have to insert your finger into your vagina and squeeze the Rectoseal to push the stool out. If you do this, it's very important to wash your hands thoroughly with soap and water before inserting your finger into your vagina. Otherwise, you could introduce germs.

If you also have to use your fingers to defecate, be sure to talk to a doctor about treatment.

Is a Rectocele a Hernia?

A rectocele is a hernia in which your rectum protrudes (herniates) into the wall of your vagina, similar to a hernia . However, doctors classify a rectocele as a pelvic organ prolapse, not a hernia.

Finally, a few things to keep in mind

Having a rectocele can be really uncomfortable and sometimes embarrassing. But the best part is that there are treatments for it. These treatments can help you regain control over the parts of your body that feel out of control. All you need to do is ask your doctor for help. Many people can manage the condition with physical therapy and lifestyle changes. If the prolapse is severe, your doctor may also recommend surgery that can help.

So, if you have this kind of discomfort, don't be afraid to talk about it. See a doctor immediately and get advice. Your well-being is very important to you!

` Rectocele, rectal prolapse, vaginal prolapse, pelvic organ prolapse, constipation, childbirth, pelvic floor