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A rectocele occurs when the thin wall of tissue, called the fascia, separating the rectum from the vagina weakens, allowing the front wall of the rectum to bulge into the vagina.


A small rectocele may cause no signs or symptoms. In moderate or severe cases, rectoceles can be bothersome, uncomfortable, and painful.

You may notice:

  • A soft bulge of tissue in your vagina that may or may not protrude through the vaginal opening
  • Constipation
  • Difficulty having a bowel movement
  • Sensation of rectal pressure or fullness
  • A feeling that the rectum has not completely emptied after a bowel movement
  • Sexual concerns, such as feeling embarrassed or sensing looseness in the tone of your vaginal tissue

Causes and Risk Factors

Pregnancy and childbirth are the most common causes of rectoceles because the muscles, ligaments and fascia that hold and support your vagina become stretched and weakened during pregnancy, labor and delivery. As a result, the more pregnancies you have, the greater chance you have of developing a rectocele.

Other conditions and activities that can put pressure on the pelvic floor and cause a rectocele include:

  • Chronic constipation or straining with bowel movements
  • Chronic cough or bronchitis
  • Repeated heavy lifting
  • Being overweight or obese

The following factors may increase your risk of experiencing a rectocele:

  • Some women are born with weaker connective tissues in their pelvic area, making them naturally more likely to develop a rectocele.
  • Your risk of a rectocele increases as you age because you naturally lose muscle mass, elasticity and nerve function as you grow older, causing muscles to stretch or weaken.

Diagnostic Tests

In most cases, your doctor diagnoses a rectocele during a pelvic examination of your vagina and rectum.

Rarely, your doctor may identify something during the physical exam that needs further evaluation.

  • Magnetic resonance imaging (MRI) or an X-ray exam, can help your doctor determine the size of the rectocele
  • Dynamic defecography to assess how efficiently your rectum empties

Treatment and Procedures

Treatment depends on the severity of the rectocele. If your rectocele causes few or no obvious symptoms, self-care measures and other nonsurgical options are often effective.

In severe cases, your doctor may suggest other treatments options:

  • A pessary, a plastic or rubber ring, is inserted in the vagina to support the bulging tissues.
  • Surgery will repair the rectocele by removing excess, stretched tissue that forms the rectocele. Occasionally, the surgical repair may involve using a mesh patch to support and strengthen the wall between the rectum and vagina

Your health is our greatest concern. Please contact the Center for Colon & Rectal Surgery at 407.303.2615 for a private consultation today.