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Tests and diagnosis
By Mayo Clinic staffIn most cases, your doctor diagnoses posterior prolapse during a pelvic examination of your vagina and rectum.
Possible tests for rectocele include:
- Pelvic exam. During the exam, your doctor may ask you to bear down as if having a bowel movement. This may cause the posterior prolapse to bulge, so your doctor can assess its size and location. To check the strength of your pelvic muscles, you may also be instructed to tighten (contract) them, as if you're stopping the stream of urine. Your doctor may examine you while lying down and while standing up.
- Questionnaire. You may fill out a form that helps your doctor assess how far the bulge extends into your vagina and how much it affects your quality of life. Information gathered also helps guide treatment decisions.
- Imaging tests. Imaging tests usually aren't needed to diagnose posterior prolapse. Rarely, your doctor may identify something during the physical exam that needs further evaluation. In that case, you may have an imaging test, such as magnetic resonance imaging (MRI) or an X-ray exam, to determine the size of the tissue bulge and how efficiently your rectum empties (defecography).
References
- Park AJ, et al. Clinical manifestations, diagnosis, and nonsurgical management of posterior vaginal defects. http://www.uptodate.com/index. Accessed May 31, 2012.
- 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.
- Culligan PJ. Nonsurgical management of pelvic organ prolapse. Obstetrics & Gynecology. 2012;119:852.
- Park AJ, et al. Surgical management of posterior vaginal defects. http://www.uptodate.com/index. Accessed June 5, 2012.
- 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.
- Hagen S, et al. Conservative management of pelvic organ prolapse. Obstetrics, Gynaecology and Reproductive Medicine. 2012;22:118.
- Lightner DJ (expert opinion). Mayo Clinic, Rochester, Minn. July 5, 2012.
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