Posterior prolapse (rectocele)

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Symptoms

By Mayo Clinic staff

A small posterior prolapse may cause no signs or symptoms. Otherwise, you may notice:

  • A soft bulge of tissue in your vagina that may or may not protrude through the vaginal opening
  • Difficulty having a bowel movement with the need to press your fingers on the bulge in your vagina to help push stool out during a bowel movement ("splinting")
  • Sensation of rectal pressure or fullness
  • A feeling that the rectum has not completely emptied after a bowel movement
  • Sexual concerns, such as feeling embarrassed or sensing looseness in the tone of your vaginal tissue

Many women with posterior prolapse also experience related conditions, such as:

  • Anterior prolapse, also known as cystocele, when the front part of the vagina bulges — most commonly it's the bladder that's bulging into the vagina
  • Apical prolapse, also known as enterocele, when the top of the vagina is pushed down — most commonly it's the small intestine that's bulging into the vagina
  • Uterine prolapse, when the uterus pushes down into the vagina

When to see a doctor
When a posterior prolapse is small, you don't need medical care. Posterior prolapse is common, even in women who haven't had children. In fact, you may not even know you have posterior prolapse.

In moderate or severe cases, however, posterior prolapse can be bothersome or uncomfortable. Make an appointment with your doctor if:

  • You have a bothersome bulge of tissue that protrudes from within your vagina through your vaginal opening when you strain.
  • Constipation treatment isn't successful at producing soft and easy-to-pass stool between three times a day to three times a week.
References
  1. Park AJ, et al. Clinical manifestations, diagnosis, and nonsurgical management of posterior vaginal defects. http://www.uptodate.com/index. Accessed May 31, 2012.
  2. Lentz GM, et al. Comprehensive Gynecology. 6th ed. Philadelphia, Pa.: Mosby Elsevier; 2012. http://www.mdconsult.com/books/linkTo?type=bookPage&isbn=978-0-323-06986-1&eid=4-u1.0-B978-0-323-06986-1..C2009-0-48752-X--TOP. Accessed June 4, 2012.
  3. Culligan PJ. Nonsurgical management of pelvic organ prolapse. Obstetrics & Gynecology. 2012;119:852.
  4. Park AJ, et al. Surgical management of posterior vaginal defects. http://www.uptodate.com/index. Accessed June 5, 2012.
  5. Rogers RG, et al. An overview of the epidemiology, risk factors, clinical manifestations, and management of pelvic organ prolapse in women. http://www.uptodate.com/index. Accessed June 5, 2012.
  6. Hagen S, et al. Conservative management of pelvic organ prolapse. Obstetrics, Gynaecology and Reproductive Medicine. 2012;22:118.
  7. Lightner DJ (expert opinion). Mayo Clinic, Rochester, Minn. July 5, 2012.
DS00704 Aug. 1, 2012

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