Rectocele

Prevention

During delivery, some doctors cut the skin between the vagina and the rectum to enlarge the opening. This procedure is called an episiotomy. As late as the 1980s, many doctors believed that doing a routine episiotomy during vaginal delivery would help to prevent a woman from developing a rectocele later in life. Now, however, there is some evidence that rectoceles may develop near healed episiotomies. Currently, doctors don't do this procedure as often, and they usually discuss the risks and benefits of this procedure with their pregnant patients in the weeks before delivery. Episiotomy is no longer done for every vaginal delivery and many doctors and midwives go to great lengths to avoid doing the procedure unless absolutely necessary.

Some health experts believe that Kegel exercises can either help to prevent a rectocele or relieve some of its symptoms. Kegel exercises are muscle-strengthening maneuvers that help to tighten the tissues around the vagina, but they have not been proven to prevent rectoceles.

Treatment

If you are troubled by symptoms of a rectocele, you doctor likely will do surgery to repair the weakness in the fascia between your rectum and vagina. This repair may be done by reinforcing the area with stitches, or it may involve more complex techniques, such as placing a mesh patch to strengthen and support the wall between the rectum and vagina. If you also have a cystocele or uterine prolapse, then surgery to repair these conditions usually can be done at the same time as your rectocele repair.

A nonsurgical treatment called a vaginal pessary is available as an alternative. A pessary is a device shaped like a ring, block or plug that is placed into the vagina to support the bulging tissues. Several types of pessaries are in use, some that you may be able to remove and clean daily, others that may require a doctor's visit for periodic removal and cleaning. Your doctor will decide which type of pessary is best for you, and will make sure it fits properly.