Rectocele or posterior vaginal prolapse is a condition where the vaginal walls tend to bulge. This occurs when the thin tissue that separates the vagina from the rectum, known as the rectovaginal septum, weakens. The severity of posterior vaginal prolapse can range from small to fatal. When the rectocele is small, the affected woman would not experience any symptoms.


The exact cause of Rectocele has not yet been identified. However, posterior vaginal prolapse usually occurs as a result of pressure exerted on the pelvic floor. There are many reasons for this increased pelvic floor pressure. One of the most significant reasons is vaginal delivery. During childbirth, the vaginal walls, ligaments, tissues, and muscles become stretched, and this can lead to posterior vaginal prolapse.

The chances increase if a woman went through trauma during delivery. Note that birthing trauma usually occurs in the case of forceps delivery, tearing with a vaginal delivery, vacuum delivery, episiotomy during delivery, etc. The chances for women who have had cesarean deliveries developing rectocele, is considerably less when compared to those who have had vaginal deliveries. However, women who haven’t had children as well can suffer from posterior vaginal prolapse. Apart from this, some of the other important reasons which may exert pressure on the pelvic floor are listed below.

  • Chronic constipation
  • Chronic bronchitis or cough
  • Obesity
  • Repeated heavy weight lifting
  • Age
  • Multiple Rectal surgeries


As mentioned earlier, most women would experience no symptoms when severity is low. In fact, they would normally only find out about the Rectocele during a regular physical check-up. On the other hand, sufferers may notice several symptoms if the posterior vaginal prolapsed is severe. The signs which you must look for include the following.

  • A small bulging tissue which projects outward through the vaginal opening
  • A sensation of feeling full, or rectal pressure
  • Difficulty with bowel movements
  • A feeling that the rectum is not empty, even after frequent bowel movement
  • Sexual concerns
  • Vaginal bleeding

If you notice any of these symptoms, it is recommended to consult a doctor right away, since these symptoms usually occur only in severe cases. Note that other pelvic parts such as the small intestine or bladder can bulge into the vagina, resulting in almost the same symptoms. So, a proper check-up is important to properly diagnosing the condition. In the next article we’ll outline some of factors that may raise the chances of experiencing rectocele as well diagnosis, prevention, and treatment.

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    About the Author

    Dr. Ghassan M. Al-Jazayrly, MD

    A graduate of University of Aleppo Faculty of Medicine, Dr. Al-Jazayrly or, as he is colloquially known: Dr. AJ, is an oncologist and hematologist of a Complete Care Community Health Center (CCCHC) with more than 36 years of experience. In recent years, he’s been involved with a non profit organization known as Every Woman Counts (EWC) which provides free breast and cervical cancer screening and diagnostic services to California’s underserved populations in order to eliminate health disparities for low-income individuals.

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