Description

A posterior vaginal prolapse is a protrusion of tissue inside the vagina. This happens when the tissue between the rectum and the vagina weakens or tears. This causes the rectum to push into the vaginal wall. Posterior vaginal prolapse is also called a rectocele (REK-toe-seel).

Delivery-related, the tears, the chronic straining to pass stool (constipation), and other activities that put pressure on pelvic tissues can lead to posterior vaginal prolapse. A small prolapse may cause no symptoms.

With a big prolapse, you might notice a lump of tissue that pushes through the opening of the vagina. To pass stools, you might need to support the vaginal wall with the fingers. This is called the placement of a splint. The lump may be uncomfortable, but is rarely painful.

If necessary, measures of self-care and other non-surgical options are often effective. Severe posterior vaginal prolapse, you may need surgery to fix it.

Symptoms

A small vaginal prolapse, posterior (rectocele) may not cause symptoms.

Otherwise, you may notice:

  • A soft bulge of tissue in the vagina that can come through the opening of the vagina
  • Difficulty having a bowel movement
  • Feeling of pressure or fullness in the rectum
  • A feeling that the rectum has not been completely emptied after a bowel movement
  • Sexual problems, such as the feeling of shame or detection of slack in the tone of the vaginal tissue

Many women with prolapse of the posterior vaginal also have prolapse of other pelvic organs, such as the bladder or uterus. A surgeon can evaluate the prolapse and talk about the options of surgery to fix it.

When to see a doctor

Sometimes, posterior vaginal prolapse may cause no problems. But moderate or severe posterior vaginal prolapses could be uncomfortable. Consult a health care professional if your symptoms affect your day-to-day life.

Causes

Posterior vaginal prolapse results of the pressure on the pelvic floor or trauma. Causes of the increase in pelvic floor pressure include:

  • Related to the birth of tears
  • Forceps or operative vaginal deliveries
  • Long-term constipation or straining with bowel movements
  • Long duration of cough or bronchitis
  • Repeated lifting of heavy objects
  • Overweight

Pregnancy and childbirth

The muscles, ligaments and connective tissue that hold the vagina of stretching during pregnancy, labor and delivery. This can make the tissues more weak and less support. The greater number of pregnancies you have, the greater your chance of developing vaginal prolapse later.

If you've only had cesarean deliveries, are less likely to develop vaginal prolapse later. But you could still develop the condition.

Risk factors

Any person with a vagina can develop vaginal prolapse later. However, the following might increase the risk of:

  • Genetics. Some people are born with weaker of the connective tissues in the pelvic area. This makes them naturally more likely to develop vaginal prolapse later.
  • Delivery. Having vaginal delivered more than a child increases the risk of subsequent development of vaginal prolapse. Tears in the tissue between the vaginal opening and the anus (perineal tears), or cuts that make the vaginal opening larger (on average) during labor and delivery can also increase the risk. Operative vaginal deliveries, and tweezers in particular, increase the risk of developing this condition.
  • Aging. Every time major causes of loss of muscle mass, the elasticity and the function of the nerves, which causes the muscles to stretch or weaken.
  • Obesity. Excess body weight puts pressure on the pelvic floor tissues.

Prevention

To help maintain posterior vaginal prolapse from getting worse, you can try:

  • To perform Kegel exercises regularly. These exercises can strengthen the pelvic floor muscles. This is especially important after having a baby.
  • Treat and prevent constipation. Drink plenty of fluids and eat high-fiber foods, such as fruits, vegetables, legumes and whole grain cereals.
  • Avoid lifting heavy objects and lift correctly. The use of legs in place of the waist or in the back to lift.
  • Control the cough. Receive treatment for a chronic cough or bronchitis, and do not smoke.
  • Avoid weight gain. Ask your health care provider to help you determine the best weight for you. Ask for advice on how to lose weight, if necessary.

Diagnosis

A diagnosis of prolapse of the posterior vaginal often occurs during a pelvic exam of the vagina and the rectum.

The pelvic exam may include:

  • Bearing down as if having a bowel movement. Bearing down can cause prolapse of the bulge, revealing its size and location.
  • Stretching the muscles of the pelvis, as if stopping a stream of urine. This test checks the strength of the muscles of the pelvis.

You could fill out a questionnaire to assess their condition. Their answers may tell your health care provider about the extent to which the bundle extends into the vagina and how much it affects their quality of life. This information helps guide treatment decisions.

Rarely, you might need a test image:

  • MRIor an X-ray can determine the size of the lump of fabric.
  • Defecography is a test to check how well your rectum empty. The procedure combines the use of a contrast agent with an imaging study, such as X-rays or magnetic resonance imaging .

Treatment

The treatment depends on the severity of the prolapse. Treatment may include:

  • Of the observation. If the back of the vaginal prolapse causes few or no symptoms, simple self-care measures — such as the performance of Kegel exercises to strengthen the muscles of the pelvis — I could give relief.
  • Pessary. A vaginal pessary is a silicone device that is placed in the vagina. The device helps to support the bulging of the tissues. A pessary should be removed periodically for cleaning.

Surgery

The surgery to correct the prolapse may be needed if:

  • The strengthening pelvic floor exercises or the use of a pessary does not control their prolapse symptoms well enough.
  • Other pelvic organs are prolapsed along with the rectum, and its symptoms are really annoying. The surgery to correct each organ prolapse can be done at the same time.

The surgery often involves the removal of extra, stretches the tissue that forms the bulk vaginal. Then, the points are placed to support structures of the pelvis. When the uterus is also prolapse, the uterus may need to be removed (hysterectomy). More than one type of prolapse can be repaired during the same surgery.

Lifestyle and home remedies

Sometimes, self-care measures to provide relief of the symptoms of the prolapse. You may want to try:

  • To perform Kegel exercises to strengthen pelvic muscles
  • Avoid constipation by eating food rich in fiber, drink plenty of fluids and, if necessary, take a fiber supplement
  • Avoid straining during bowel movements
  • Avoid lifting heavy objects
  • The Control of the cough
  • Achieve and maintain a healthy weight

Kegel exercises

Kegel exercises strengthen the pelvic floor muscles. A strong pelvic floor provides a better support for the pelvic organs. It can also relieve the bulk of the symptoms of posterior vaginal prolapse may cause.

To perform Kegel exercises:

  • Find the right muscles. To find the pelvic floor muscles, try to stop your urine midstream when you use the toilet. Once you know where these muscles, you can practice these exercises. You can do the exercises in any position, although you might find it easier to do lying down at first.
  • Perfect your technique. To do Kegels, imagine you are sitting on a marble and tighten your pelvic muscles as if you're lifting the marble. Try it for three seconds, then relax for a count of three.
  • Keep your focus. For best results, focus on tightening only your pelvic floor muscles. Be careful not to flex the muscles in your abdomen, thighs or buttocks. Avoid holding your breath. Instead, breathe freely during the exercises.
  • Repeat three times a day. Aim for at least three sets of 10 to 15 repetitions per day.

Kegel exercises may be most successful when they are taught by a physical therapist or a nurse practitioner, and reinforced with biofeedback. Biofeedback uses monitoring devices to let you know that you're squeezing the set of muscles in the correct way.

Preparing for your appointment

For posterior vaginal prolapse, it is possible that you need to see a doctor who specializes in female pelvic floor conditions. This type of doctor is called a urogynecologist.

Here's some information to help you prepare for your appointment.

What you can do

Make a list of:

  • Your symptoms and when they began
  • All the drugs, vitamins, and supplements you are taking, including dose
  • The key to personal and medical information, including other conditions, recent life changes, and the factors of
  • Questions to ask your health care provider

For posterior vaginal prolapse, some basic questions to ask your doctor include:

  • What can I do at home to relieve the symptoms?
  • Should I restrict any activity?
  • What are the chances that the lump grow if I don't do anything?
  • What treatment approach do you think would be best for me?
  • What are the chances of my state return after I have the surgery?
  • What are the risks of the surgery?

Be sure to ask any questions that occur during your appointment.

What to expect from your health care provider

Your provider is likely to ask a series of questions, including:

  • Do you have pain in the pelvis?
  • Do you ever leak urine?
  • Has had a severe or continuous cough?
  • Do any heavy work in your work or daily activities?
  • Do you strain during bowel movements?
  • Anyone in your family ever had pelvic organ prolapse or other pelvic problems?
  • How many children have you given birth? Were their vaginal births?
  • Do you plan to have children in the future?
Symptoms and treatment of vaginal prolapse Posterior (rectocele)