Prolapse of the posterior (back) vaginal wall
Rectocele (prolapse of the rectum) - This type of vaginal prolapse involves a prolapse of the back wall of the vagina (rectovaginal fascia). Rectoceles and enteroceles develop if the lower pelvic muscles become damaged by pregnancy, labour, childbirth, or a previous pelvic surgery or when the muscles are weakened by aging. When this wall weakens, the rectal wall pushes against the vaginal wall, creating a bulge. This bulge may become especially noticeable during bowel movements. Rectocele and enterocele formation may occur together, especially in women who have had a hysterectomy (removal of the uterus or womb).
Enterocele (prolapse of the small bowel) - Part of the small intestine that lies just behind the uterus (in a space called the pouch of Douglas) may slip down between the rectum and the back wall of the vagina. This often occurs at the same time as a rectocele or uterine prolapse.
Rectocele (prolapse of the rectum or large bowel) - This occurs when the end of the large bowel (rectum) loses support and bulges into the back wall of the vagina. It is different from a rectal prolapse (when the rectum falls out of the anus). A rectocele or an enterocele may become large or more obvious when a woman strains or bears down during a bowel movement.
Symptoms
May cause constipation or difficulty defecating (Some women need to insert a finger in their vagina and push the bowel back into place in order to empty their bowels correctly)
Pelvic pain and lower back pain
Pain during sexual intercourse.
Treatment
Eat a high fibre diet with plenty of fresh fruits, vegetables and wholegrain bread and cereal, to prevent constipation and reduce straining.
Perform regular pelvic floor exercises. These help strengthen weakened muscles, aid recovery after pelvic surgery, and will reduce symptoms like leaking urine and backache.
Surgical repair of rectoceles and enteroceles is used to manage symptoms such as bulging (prolapse) of the intestine into or out of the vagina, low back pain, and painful intercourse. An enterocele may not cause symptoms until it is so large that it bulges into the midpoint of the vaginal canal.
Prevention
To reduce the risk of prolapse of the rectum (rectocele and enterocele), or prevent it from worsening practice the following:
Avoid standing for long periods of time.
Eat a high fibre diet with plenty of fresh fruits, vegetables and wholegrain bread and cereal, to prevent constipation
and reduce straining.
Do regular pelvic floor exercises. These help strengthen weakened muscles, aid recovery after pelvic surgery, and may reduce symptoms like leaking urine and backache.
Lose weight and maintain a healthy weight
Avoid heavy lifting and straining.
Read about Bladder and Urethra Prolapse
Prolapse of the Rectum
Prolapse of the Uterus
Pelvic Organ Prolapse
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