Rectocoele

In women, a wall of tough, fibrous tissue (fascia) separates the rectum from the vagina. Most rectoceles occur in women where the front wall of the rectum is up against the back wall of the vagina. A rectocele occurs when this fascia weakens, allowing the front wall of the rectum to bulge into your vagina. A rectocele occurs when the rectum pushes the back wall of the vagina forward, causing a prominent bulge into the vagina. Risk factors include difficult childbirth and the use of forceps during delivery, but women who have never had children can also develop rectocele. Moderate cases may involve difficulty passing stool (because the attempt to evacuate pushes the stool into the rectocele instead of out through the anus ), discomfort or pain during evacuation or intercourse, constipation , and a general sensation that something is "falling down" or "falling out" within the pelvis . Mild (small) rectoceles may cause no signs or symptoms. More severe (large) rectoceles may cause a noticeable bulge of tissue through the vaginal opening. Though this bulge may be uncomfortable, it's rarely painful. It may coexist with a bulging from the bladder, urethra, and intestines (cystocele, urethrocele, and enterocele), or with uterine or vaginal prolapse (slipping downward), rectal prolapse, and fecal or urinary incontinence. The treatment may be medical or surgical. Medical options include a high fiber diet and ample fluids (to avoid constipation), stool softeners, and a pessary inserted into the vagina to support the pelvic organs. Surgery is meant to repair the rectocele.

A cystocele occurs when part of the bladder bulges into the vagina. It's most common after menopcele may be felt as a small bulge high inside the vagina while, in severe cases, the bulge may be hanging outside of the vagina. The bladder bulging into the vagina is called a cystocele, and the small intestines pushing down on the vagina from above may form an enterocele. The high rectoceles are usually due to a laxity or disruption of the upper third of the vaginal wall tissue and uterosacral ligaments. Mid level rectoceles are the most common and are associated with loss of pelvic floor support. Low rectoceles are usually caused by obstetric trauma. Because rectocele and enterocele are defects of the pelvic supporting tissue and not the bowel wall, they are treated most successfully with surgery that repairs the vaginal wall. Unless there is another health problem that would require ause, when estrogen which helps keep your pelvic tissues strong decreases. The degree of severity varies; for example, in mild cases the rectoan abdominal incision, rectoceles and enteroceles are usually repaired through the vagina.

Causes of Rectocoele

The common Causes of Rectocoele :

• Tearing during childbirth, particularly if the tear extended from the vagina to the anus.
• Vaginal (normal) childbirth.
• Being overweight or obese.
• Episiotomy (a surgical cut made to enlarge the vaginal opening during childbirth to avoid injury to mother and baby), particularly if the cut extends to the anus.
• Repeated heavy lifting.
• Pelvic surgery.
• Chronic constipation or straining with bowel movements.

Symptoms of Rectocoele

Some common Symptoms of Rectocoele :

• Symptoms are worsened by standing up and eased by lying down.
• Low back pain that's relieved when you lie down.
• A feeling that the rectum has not completely emptied after a bowel movement.
• Problems with passing a bowel motion, since the stool becomes caught in the rectocele.
• Pelvic pressure in the rectal area.
• Difficulty controlling the passage of stool.
• Constipation.
• Vaginal bleeding that's not related to the menstrual cycle.
• Protrusion of the lower part of the vagina through the opening of the vagina.

Treatment of Rectocoele

• Squeezing the muscles in your genital area may help strengthen your muscles and be of some help.
• Surgical repair may be necessary. In some cases the uterus may need to be taken out (a hysterectomy) to prevent recurrence surgery is usually very effective and will be a lasting cure as long as you maintain a healthy lifestyle and weight.
• Hormone replacement therapy for postmenopausal women.
• The insertion of a pessary, which is a ring-like device worn high in the vagina that helps to support the pelvic organs.
• Your doctor may recommend using estrogen either orally or in a vaginal cream if you've already experienced menopause this is because estrogen, which helps keep pelvic muscles strong, decreases after menopause this approach may slow progression of a rectocele, but it will usually not cure the problem.
• Instruction on how to help yourself to pass a bowel motion; for example, you may be advised to gently press a finger against the rear wall of the vagina while toileting.

Women's Health

Adenomyosis
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Rectocoele
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Wernicke korsakoff synodrome