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Rectocoele


WHAT IS IT?

Rectocoele (or rectocele) is a weakness of the rectum. On straining, this weakness may bulge out into the vagina (marked in red on the diagram) or into surrounding tissues. It very occasionally occurs in men, but is quite uncommon due to the narrow pelvis and the protective presence of the prostate. It is, however, very common in women. The tissues between the rectum and vagina (the rectovaginal septum) are weak by design to make childbirth possible.

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WHAT CAUSES A RECTOCOELE?

The most common cause for rectocoele is excessive stretching of the rectovaginal septum from giving birth, in particular multiple, difficult births. Repeated straining due to constipation or anismus may also precipitate the problem. It usually occurs in association with other pelvic floor problems such as intussusception or prolapse.

WHAT SYMPTOMS DOES IT CAUSE?

The most common symptom of a rectocoele is a lump in the vagina where the rectum bulges into it. Rectal symptoms include difficulty with emptying the bowels and a sensation that stool is getting trapped during attempts to open the bowels. Trapped bits of stool can leak after visits to the toilet. Many patients have to press with the finger on the back wall of the vagina or on the perineum (the skin between the anal canal and vaginal opening) or in the anus to help them to empty.

HOW IS IT DIAGNOSED?

We often suspect the diagnosis on the basis of symptoms and examination in clinic. You may need tests and a proctogram is the one that usually confirms the diagnosis.

HOW CAN IT BE TREATED?

In case of an isolated rectocoele, a rectocoele repair or STAMP is usually performed through the anal canal. If there are other associated problems, laparoscopic ventral rectopexy through the abdomen may be more appropriate.


Please be advised that the information on this website is not a substitute for professional medical advice, diagnosis or treatment