Rectocele

WHAT YOU SHOULD KNOW:

• A rectocele (REK-to-sel), also called vaginal hernia, occurs when a part of the rectum bulges down into the vagina. It is often caused by weak muscles and ligaments that hold and support the vagina and rectum. This may be caused by aging, surgery, straining, pregnancy, or trauma during labor or delivery of a baby. There may be no signs or symptoms, or you may feel a bulge in your vagina that may come out through the vaginal opening. You may also have rectal pain, trouble having a bowel movement (BM), , or a feeling of fullness in your rectum.
  
  
• Your caregiver will be able to find your rectocele by doing a physical exam. You may need other tests, such as a barium enema, colonoscopy, MRI, or ultrasound. Treatment may include a high fiber diet, biofeedback therapy, or estrogen medicine. A pessary (ring-like device) placed inside your vagina may help support your rectum. You may need surgery to repair the weak or thin muscles around your vagina and rectum. With treatment your symptoms, such as back pain and constipation, may go away.

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

RISKS:

Estrogen medicine may increase your risk of having irregular vaginal bleeding or cancer. The use of a pessary may cause infection, discomfort, or it may fall out. There are risks when having surgery, such as infection or bleeding. If a rectocele is not treated, you may keep having pain with sex or bowel movements. A rectocele may also cause a bowel obstruction (blockage). If the rectocele pushes out of your vaginal opening, it is harder to treat, and other medical problems can develop. Ask your caregiver if you are worried or have questions about your condition, medicine, or care.

WHILE YOU ARE HERE:

Informed consent: You have the right to understand your health condition in words that you know. You should be told what tests, treatments, or procedures may be done to treat your condition. Your doctor should also tell you about the risks and benefits of each treatment. You may be asked to sign a consent form that gives caregivers permission to do certain tests, treatments, or procedures. If you are unable to give your consent, someone who has permission can sign this form for you. A consent form is a legal piece of paper that tells exactly what will be done to you. Before giving your consent, make sure all your questions have been answered so that you understand what may happen.

Activity: You may need to rest in bed. Your caregiver will tell you when it is OK to get out of bed. Call your caregiver before getting up for the first time. If you feel weak or dizzy, sit or lie down right away.

Blood tests: You may need blood taken for tests. The blood can be taken from a blood vessel in your hand, arm, or the bend in your elbow. It is tested to see how your body is doing. It can give your caregivers more information about your health condition. You may need to have blood drawn more than once.

Medicines:

• Antibiotics: Antibiotics may be given to help treat or prevent an infection caused by germs called bacteria.
  
  
• Estrogen medicine: If you are in menopause, your caregiver may suggest estrogen hormones. This may be taken as a pill by mouth or applied as a cream in your vagina. Estrogen helps keep your pelvic muscles strong and may prevent your rectocele from getting worse.
  
  
• Pain medicine: Caregivers may give you medicine to take away or decrease your pain. Medicine may be given regularly, or may only be given if you ask caregivers for it. Tell caregivers if your pain does not decrease enough for you to feel better. Do not wait to ask for your pain medicine until the pain is very bad. The medicine may not work as well at controlling your pain if you wait too long to take it. Ask your caregiver for help getting out of bed if you feel tired or dizzy.
  
  
• Stool softeners: You may be given stool softeners to soften your bowel movements, making them easier to pass.

Treatment options: You may have one or more of the following:

• Biofeedback therapy: Biofeedback uses special equipment to train you how to control and relax your pelvic muscles. Ask your caregiver for more information about biofeedback.
  
  
• Pessary: A pessary is a plastic or rubber ring that is placed inside the vagina. This supports the bulging tissues in your vagina and rectum.
  
  
• Surgery: You may need to have surgery to move your rectum back into place. The muscles and ligaments around your vagina may be sutured (tied up) to make them strong. A mesh patch may also be used to add support to the rectovaginal septum.

Copyright © 2008 Thomson Healthcare Inc. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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