Rectocele


RECTOCELE

A rectocele generally occurs as a result of child birth or a hysterectomy. It is uncommon in men but has been known to occur.

When the end of the large intestine pushes on the vaginal wall it can result in a tear in the recto-vaginal septum (this is a tough, fibrous, sheet-like divider between the rectum and vagina)

Rectal tissue bulges through this tear and into the vagina as a hernia.


Causes

· The most common cause is childbirth in particular with large weight babies. The risk increases with the number of vaginal births.

· Episiotomy or lower vaginal tears may also attribute to rectoceles.

· A hysterectomy or pelvic surgery.

· Chronic constipation and straining to pass bowel movements places pressure on the recto vaginal septum.

·Aging and older women with less estrogen can cause the spectrum to be thinner and less elastic and more prone to tearing

· Sexual abuse to children can also be a cause.

Symptoms

· A sense of pressure or protrusion within the vagina after a bowel movement

· A feeling the rectum has not been completely emptied after a bowel movement.

·Difficulty passing a stool (because the attempt to evacuate pushes the stool into the rectocele instead of out through the anus),

·Discomfort or pain during bowel evacuation

·Discomfort or pain during intercourse

·Discomfort or pain with constipation

·A feeling something is "falling down" or "falling out" within the pelvis.

·Vaginal bleeding,

·Fecal Incontinence

·Prolapse or bulge through the mouth of the vagina, or through the anus.

·Constipation


Treatment

1.   One immediate treatment could be to increase the consumption of water intake as the stools become harder to evacuate because of dehydration. Many women believe if they reduce water intake this will help their incontinence. This is not a good practise because the stools become harder and the urine becomes more concentrated with toxins.

2.    Increasing fluid intake to 2 litres of water a day minimum will go a long way to helping the successful evacuation of previously harder stools. This should become a habit of drinking this quantity of water a day for several reasons:

ü  Softens stools to evacuate easier therefore less straining and pushing

ü  Rids the body of stools that may ‘dwell’ in the large intestine longer than they should.

ü  Rids the body of toxins.

ü  Promotes cell health and function and reduces inflammation.

3.   Change the diet to increase fibre and fruit and veges.

4.   Stop smoking.

5.   Get your weight to a normal level if you are overweight.

6.  Strengthen the pelvic floor muscles to make the uro genital area stronger and healthier. If you don’t know how to do them properly click here.

7  If water does not have immediate effects try stool softners  to start with and hormone replacement therapy for post-menopausal women.

Surgery

 Surgery to correct the issue is performed through the mouth of the vagina by suturing and repairing the recto-vaginal septum.

It is a relatively simple procedure for an urologist or gynecologist to correct and can be performed with a local or general anesthetic.

 This surgery pulls together the stretched or torn tissue in the area of prolapse. Surgery will also strengthen the wall of the vagina to prevent prolapse from recurring.

 Following surgery you may stay in the hospital from 1 to 2 days and return to  normal activities in about 4-6 weeks being careful not to strain and keep the fluid intake up with normal bowel function in 2 -3 weeks.


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