- A rectocele affects the back wall of the vagina.
- 'Splinting' to empty the bowels is a strong sign.
- Repair is typically with your own tissue, not mesh.
What is a rectocele?
The rectum sits behind the back wall of the vagina, separated by a layer of connective tissue called the rectovaginal septum. When that layer weakens, the rectum bulges forward into the vagina. This is a rectocele, or posterior vaginal wall prolapse.
How it presents
Women often describe a soft bulge at the back of the vagina, a feeling of incomplete bowel emptying, needing to press on the vagina or perineum to open the bowels (called 'splinting'), constipation, and discomfort during sex. It is common to have a rectocele alongside a cystocele or a uterine prolapse.
Treatment
Mild rectoceles are managed with a high-fibre diet, adequate hydration, laxatives if needed, and pelvic floor rehabilitation to retrain the puborectalis muscle. When splinting or obstructed defecation is present, surgical repair (posterior colporrhaphy with perineal reconstruction) restores the support layer using native tissue.
UK context
Many British women live with a rectocele for years because their GP is not trained to examine for it. A single, unhurried gynaecological examination — combined with a defecatory questionnaire — is usually enough to establish the diagnosis and stage it.
Frequently asked questions
Is a rectocele the same as a bladder prolapse?
No — a cystocele is at the front of the vagina, a rectocele is at the back. They often coexist.
Do I need mesh to repair a rectocele?
Almost never. Native-tissue posterior repair remains the gold standard.
How long is recovery?
Most women return to office work in two to three weeks and to exercise in six.
Could a doctor-led plan help you?
A 30-minute video consultation with Dr Berra Önsoy — reviewing your symptoms, any UK imaging or referral notes, and giving you a clear, personalised next step. Suitable for women considering treatment from anywhere in the UK.
Request a video consultation