A posterior prolapse occurs when the thin wall of fibrous tissue (fascia) that separates the rectum from the vagina weakens, allowing the vaginal wall to bulge. Posterior prolapse is also known as Rectocele because typically, though not always, it’s the front wall of the rectum that bulges into back wall of the vagina.
If needed, self-care measures and other nonsurgical options are often effective. In severe cases, you may need surgical repair.
A small posterior prolapse may cause no signs or symptoms and some women may not even have any symptoms. The reason thereof is the fact that condition is only discovered during an internal examination for another reason, such as a cervical smear test. However, many women will experience an uncomfortable sensation of something coming down or out of the vagina. They may notice:
- A soft bulge of tissue in the vagina that may or may not protrude through the vaginal opening;
- Difficulty having a bowel movement with the need to press the fingers on the bulge in the vagina to help push stool out during a bowel movement;
- Sensation of rectal pressure or fullness;
- Difficulty going to the toilet;
- Difficulty in emptying the bowel;
- Sexual concerns, such as feeling embarrassed or sensing looseness in the tone of the vaginal tissue;
- Many women with posterior prolapse also experience prolapse of other pelvic organs, such as the bladder, uterus or small intestine.
Prolapse is caused by weakening of tissues that support the pelvic organs. There is rarely a single cause, but it is usually the result of a combination of things. For example, childbirth and other processes that put pressure on the fascia can lead to this condition, especially if the labour is difficult or the woman gives birth to multiple babies. The risk of developing pelvic organ prolapse can also be increased by:
- Changes caused by the menopause, such as weakening of tissue and low levels of estrogen;
- Being overweight or obese, which creates extra pressure in the pelvic area;
- Previous pelvic surgery;
- Repeated heavy lifting and manual work;
- Long-term coughing ;
- Excessive straining when going to the toilet because of long-term constipation.
The following factors may increase the risk of experiencing posterior prolapse:
- Women who are born with weaker connective tissues in the pelvic area;
- Women who give birth to multiple babies at once;
- Elderly women, since they naturally lose muscle mass, elasticity and nerve function as you grow older;
- Obese women.
To reduce the risk of worsening posterior prolapse, try these self-care measures:
- Perform Kegel exercises on a regular basis in order to strengthen the pelvic floor muscles;
- Treat and prevent constipation;
- Avoid heavy lifting and lift correctly;
- Control coughing;
- Maintaining a healthy weight;
- Eating a high-fiber diet with plenty of fresh fruit, vegetables and wholegrain bread and cereal to avoid constipation and straining when going to the toilet.