Urogynecology Expert Forum
Rectocele postpartum - Does it get better or is surgery needed?
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Questions in the Urogynecology forum are answered by Bruce Crawford, MD, J. Kyle Mathews, MD, and other medical professionals and experts. Topics covered include overactive bladders, bladder pain, fallen/drooping bladder, bowel urgency, bowel prolapse, cystitis, incontinence, pain with intercourse, rectal prolapse, surgery, urinary urgency, and uterine prolapse.

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Rectocele postpartum - Does it get better or is surgery needed?

I was diagnosed with rectocele after delivering my 4th child.  I know what it is. I know why it happened. Can it get better with the postpartum patient? I was told that because I delivered posterior and had 2nd degree tearing and have lower estrogen r/t breastfeeding that this is what happens. Are there exercises I can do? Are there exercises to avoid? I here Kegels are good for vaginal toning, but not for rectoceles? What can you tell me about remedies for this issue nonsurgically related. Is this common for many postpartum moms, but it gets better? Any info is greatly appreciated as I am trying to chase around after 4 kids physcially.
Thanks
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Most women will have some descent of the vaginal walls after vaginal delivery. Usually, the descended walls stay behind the labia, and are not considered to be a problem. Sometimes, the bulge descends past the labia, and can becoms visible beyond the labia.
Women with such advanced prolapse usually have symptoms of pelvic/rectal pressure, stool trapping, difficulty with intercourse, and difficulty emptying their bowels.

Women with advanced rectal prolapse cannot usually make it better with exercises. sometimes pessaries (vaginal inserts) can help, other times, surgery to correct the prolapse is needed. Often, the surgery can be done through the vagina.

It is important to know that the rectocele repair is necessary only if it bothers you with the above symptoms, or if the bulge moves past the labia, and is uncomfortable, or presents a hygenic problem.
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J. Kyle Mathews, MD, DVMBlank
Plano Urogynecology Associates
Plano, TX
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