Posterior Vaginal Prolapse Rectocele – Diagnosis and Treatment
Diagnosis
Doctors often use a pelvic exam to identify rectocele or posterior vaginal prolapse. During this exam, the provider may ask the patient to bear down as if having a bowel movement.
This action reveals any bulging tissue from the rectum into the vaginal wall.
Sometimes, the provider asks the patient to tighten their pelvic muscles, similar to stopping urine, so they can check pelvic muscle strength. These simple movements help the provider determine the location and severity of the prolapse.
Tools Used in Diagnosis:
- Pelvic Exam: Checks for bulging and muscle strength
- Questionnaire: Assesses symptoms, daily impact, and effects on quality of life
- Imaging Tests: MRI and X-ray may provide more detail if needed
- Defecography: Medical imaging that studies how the rectum empties
Doctors look for symptoms like rectal or vaginal bulging, trouble urinating, or pelvic pressure. These steps help them plan treatment and consider risk factors linked to pelvic floor muscle weakness, childbirth, or aging.
Managing and Addressing Prolapse
Surgical Procedures
Surgeons usually consider surgical options when other treatments do not bring enough relief. The doctor may suggest surgery if pelvic floor exercises or the use of a vaginal pessary no longer help.
In many cases, surgeons remove stretched tissue and use stitches to strengthen the weakened pelvic wall.
Surgeons can repair more than one organ at the same time if needed. If the uterus has also moved, they may perform a hysterectomy (removal of the uterus) as part of the procedure.
Surgeons choose traditional, minimally invasive, or reconstructive techniques based on the patientโs needs.
Surgical Options Table
| Type of Surgery | Purpose | Other Notes |
|---|---|---|
| Rectocele Repair | Supports vaginal wall and removes extra tissue. | May combine with other repairs. |
| Hysterectomy | Removes uterus if prolapse is present. | Sometimes included in the same case. |
| Mesh or Stitches Used | Holds pelvic organs in place. | Choice depends on patientโs health. |
Daily Habits and Self-Care at Home
Pelvic Muscle Strengthening (Kegel Techniques)
Strengthening the pelvic floor muscles can help support the organs in the pelvis and reduce symptoms related to rectocele.
Kegel exercises often help for this purpose. These exercises target the muscles that help hold up the bladder, uterus, and rectum.
How to Find the Right Muscles:
- To identify your pelvic floor muscles, try to stop the flow of urine while using the bathroom. The muscles you use for this are the ones to focus on when exercising.
How to Practice:
- Sit or lie down comfortably.
- Tighten the pelvic muscles as if lifting something small and delicate, like a marble.
- Hold the squeeze for three seconds, then relax for another three seconds.
- Try not to tighten the stomach, legs, or glutes during each repetition.
- Breathe normally throughout the exercises.
Routine to Follow:
- Do at least three sets each day, with 10 to 15 squeezes per set.
Tips for Best Results:
- Staying consistent is key. It may help to set a reminder.
- Working with a healthcare professional, such as a physical therapist, can provide helpful feedback and make sure you perform the exercises correctly.
Supporting Table of Healthy Lifestyle Habits
| Habit | Benefit |
|---|---|
| Eating high-fiber foods | Prevents constipation and reduces straining. |
| Drinking plenty of water | Keeps digestion regular. |
| Managing body weight | Lowers pressure on the pelvic floor. |
| Avoiding heavy lifting | Prevents extra stress on pelvic muscles. |
| Treating chronic cough | Lessens strain from repeated coughing. |
| Quitting smoking | Supports better overall pelvic health. |
Making small adjustments, like getting more fiber, staying active, and avoiding heavy weights, can also make a difference. Working with healthcare providers may provide extra support to learn proper techniques and make safe changes.
Getting Ready for Your Visit
Steps You Can Take Before Your Appointment
Being prepared can help make the most out of the visit. Here are some tips:
- Write down your symptoms. List any changes, discomfort, or concerns. Include when each symptom began.
- Record your medications and supplements. Bring a complete list, including vitamins, over-the-counter drugs, and all doses.
- Collect your health history. Note other medical conditions, ongoing treatments, and major life changes or stresses.
- Prepare your questions. Consider asking about ways to relieve symptoms at home, limits on activity, risks involved with treatment, and the chances of the prolapse returning after treatment or surgery. Some may find it helpful to keep their questions in a notebook.
Sample Questions to Ask a Health Care Provider:
| Questions to Ask |
|---|
| What can I do to ease my symptoms at home? |
| Are there activities I should avoid? |
| How likely is it that the bulge will worsen if untreated? |
| Which treatment do you recommend and why? |
| What are the risks and possible side effects of surgery? |
| Could this happen again after surgery? |
A gynecologist or a prevention-focused urogynecologist can provide more specialized advice for pelvic health.
How Your Provider Will Approach the Visit
During your appointment, the provider will likely ask questions to better understand your situation:
- Do you have any pelvic pain or pressure?
- Do you ever experience urine leakage?
- Do you have a frequent, persistent cough?
- Are you exposed to heavy lifting in daily life or work?
- Do you tend to strain during bowel movements?
- Is there a family pattern of pelvic floor or organ problems?
- How many children have you given birth to, and were the births vaginal?
- Are you planning more children in the future?
