Overview
Diagnosis
Diagnosis of posterior vaginal prolapse, or rectocele, begins with a pelvic exam. During the exam, a healthcare professional checks for a bulge in the back wall of the vagina that becomes more noticeable when you bear down. You may be asked about symptoms such as difficulty with bowel movements, pressure in the pelvis or vagina, and the feeling of tissue protruding.
Tests may be used if more detail is needed or if other pelvic floor disorders are suspected. These may include imaging studies, such as MRI or defecography, to assess how the pelvic organs move during bowel movements. These tests help show the size of the prolapse and any related conditions that may influence treatment.
Treatment
Treatment depends on the severity of symptoms, your overall health, and how the condition affects daily activities. Mild prolapse often does not require medical treatment and may improve with lifestyle changes.
Options may include:
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Lifestyle measures to relieve constipation, such as increasing fiber intake, drinking more water, and avoiding straining during bowel movements.
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Pelvic floor exercises that strengthen supporting muscles to reduce symptoms and prevent the prolapse from getting worse.
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A vaginal pessary, which is a removable device placed inside the vagina to support the prolapsed tissue and reduce pressure or bulging. It may be useful for people who wish to avoid or delay surgery.
Surgery may be recommended when symptoms are significant or do not improve with conservative treatment. The goal of surgery is to repair the weakened tissue between the rectum and vagina and restore normal support. Surgical approaches vary, and your healthcare professional will help determine the option best suited for your symptoms, anatomy, and overall health.
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