Fellowship-Trained Urogynecologist
Urogynecology & Reconstructive Pelvic Surgery
Green Bay, Wisconsin
✓ Medically reviewed May 15, 2026
What is a rectocele?
A rectocele happens when the tissue between your rectum and vagina weakens. The rectum pushes forward into the back wall of the vagina, forming a bulge. It is one of the more common types of pelvic organ prolapse.
Many women have some degree of rectocele and never know it. In fact, imaging studies find small rectoceles in nearly half of women who have no symptoms at all. It only becomes a problem when it affects your daily life.
How it develops
The back wall of the vagina is held in place by layers of connective tissue and the muscles of the pelvic floor. Childbirth, aging, chronic straining, and heavy lifting can stretch or weaken these supports at different levels.
Rectoceles tend to develop slowly. You may not notice anything until the bulge is large enough to trap stool or cause a feeling of pressure. The most common complaint I hear is trouble finishing a bowel movement.
Symptoms
- Feeling like you cannot fully empty during a bowel movement
- Needing to press on your vaginal wall or perineum to pass stool (called splinting)
- A soft bulge you can feel at the back wall of the vagina
- Pelvic pressure that gets worse with standing
- Discomfort during sex
Not every rectocele causes symptoms. The size of the bulge on exam does not always match how much it bothers you. What matters most is how it affects your quality of life.
Treatment options
There is no single right answer for every rectocele. I work with each patient to figure out what makes sense based on symptoms, goals, and preferences.
- Fiber, fluids, and stool softeners to keep bowel movements easy to pass
- Pelvic floor physical therapy, which goes well beyond Kegels. A therapist works on muscle coordination, relaxation, breathing, core and hip strength, and bowel movement technique. Our practice has in-office pelvic floor PTs who work closely with me.
- A pessary, which is a removable device placed in the vagina to support the back wall
- Posterior colporrhaphy (surgical back wall repair), which has success rates of 80 to 95 percent when symptoms are related to the prolapse
Many women with rectoceles have struggled with bowel problems for years without knowing there is a structural cause. Once we identify it, we can talk through the options and decide together what to try first.
References
- Ridgeway BM, Weinstein MM, Tunitsky-Bitton E. American Urogynecologic Society best-practice statement on evaluation of obstructed defecation. Female Pelvic Med Reconstr Surg. 2018;24(6):383-391. doi:10.1097/SPV.0000000000000635
- Grimes CL, Lukacz ES. Posterior vaginal compartment prolapse and defecatory dysfunction: are they related? Int Urogynecol J. 2012;23(5):537-551. doi:10.1007/s00192-011-1629-3
- Barber MD. Pelvic organ prolapse. BMJ. 2016;354:i3853. doi:10.1136/bmj.i3853
- Pratt T, Mishra K. Evaluation and management of defecatory dysfunction in women. Curr Opin Obstet Gynecol. 2018;30(6):420-426. doi:10.1097/GCO.0000000000000495
- Haylen BT, Maher CF, Barber MD, et al. An IUGA/ICS joint report on the terminology for female pelvic organ prolapse (POP). Neurourol Urodyn. 2016;35(2):137-168. doi:10.1002/nau.22922
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