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Rectocoele Treatment

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    Understanding Rectocele: Causes, Symptoms & Advanced Treatment

    A rectocele, also known as posterior vaginal wall prolapse, occurs when the tissue separating the rectum and vagina weakens, allowing the rectum to bulge into the vaginal wall. It is most commonly seen in women after childbirth, ageing or pelvic surgery such as a hysterectomy, although pelvic floor weakness can occasionally affect men as well. Common symptoms include constipation, difficulty passing stools, a feeling of incomplete bowel emptying, pelvic pressure and a vaginal bulge.
    At MIRA Health Care – Advanced Speciality Surgical Centre, we provide expert diagnosis and personalised treatment for rectocele and pelvic floor disorders. Depending on the severity, treatment may include lifestyle changes, pelvic floor rehabilitation or advanced minimally invasive procedures.

    Symptoms

    female

    Sense of pressure/protrusion within vagina or feeling of rectum not emptied completely after bowel movement (Mild rectocoele)

    Difficulty in passing stool, discomfort/pain during evacuation, intercourse, constipation (moderate rectocoele)

    tired

    General sensation of falling out or falling down within pelvis

    female (1)

    Vaginal bleeding, intermittent fecal incontinence, rectal prolapse

    Causes

    01

    Childbirth – rapid births or babies weighing more than 9 pounds

    02

    Episiotomy

    03

    Use of forceps during childbirth

    04

    Hysterectomy or pelvic surgery

    Treatment for Rectocele

    The treatment for rectocele depends on the severity of the condition and the symptoms experienced. Mild cases can often be managed with conservative measures, while advanced cases may require surgery to restore normal bowel function and improve quality of life.

    Non-Surgical Treatment

    Many patients with mild to moderate rectocele can benefit from non-surgical treatment, including:

    • Pelvic floor exercises (Kegel exercises) to strengthen the pelvic muscles
    • Stool softeners to reduce straining during bowel movements
    • Hormone replacement therapy (when appropriate) to improve pelvic tissue support
    • Vaginal pessary insertion to provide support for the weakened pelvic tissues

    Surgical Treatment

    Surgery is recommended when non-surgical treatments do not provide relief or when the rectocele significantly affects daily activities and bowel function. Surgical options may include:

    • Posterior colporrhaphy
    • Repair and strengthening of the rectovaginal septum
    • Mesh repair (selected cases only)
    • STARR Surgery (Stapled Transanal Resection of Rectum) – an advanced minimally invasive procedure for selected patients

    STARR Surgery for Rectocele

    STARR (Stapled Transanal Resection of Rectum) is an advanced, minimally invasive procedure used to treat rectocele and internal rectal prolapse. The procedure is performed through the anal canal using a specialised stapling device (PPH), allowing the surgeon to remove the prolapsed rectal tissue and restore the normal anatomy of the rectum without external incisions.
    Benefits of STARR Surgery
    • Minimally invasive procedure
    • No external cuts, stitches or scars
    • Day-care surgery
    • Less pain and faster recovery
    • Most patients resume normal activities within 3–4 days

    Investigations Before STARR Surgery

    Before recommending STARR surgery, your specialist may advise the following tests:
    Benefits of STARR Surgery
    • Defecography – to evaluate rectal function during bowel movements
    • Colonoscopy – to examine the colon and rule out other colorectal conditions

    Frequently Asked Questions (FAQs) – Rectocele Treatment

    Yes. Mild rectoceles can often be managed with pelvic floor (Kegel) exercises, stool softeners, dietary changes, adequate hydration and the use of a vaginal pessary, depending on the severity of the condition.
    Surgery is usually recommended when symptoms become severe, significantly affect daily activities or bowel movements, and do not improve with non-surgical treatments.
    STARR (Stapled Transanal Resection of Rectum) is an advanced minimally invasive procedure that corrects rectocele and internal rectal prolapse through the anal canal without external incisions, helping restore normal bowel function.

    STARR surgery offers several advantages, including no external cuts or scars, minimal pain, shorter hospital stay, day-care treatment and faster recovery, allowing most patients to return to normal activities within a few days.

    Recovery depends on the type of procedure performed. Most patients who undergo minimally invasive STARR surgery recover within 3–4 days, while complete healing may take a few weeks.

    At MIRA Health Care – Advanced Speciality Surgical Centre, we offer comprehensive evaluation and personalised treatment for rectocele and pelvic floor disorders. Our experienced specialists use advanced diagnostic techniques and minimally invasive procedures, including STARR surgery, to help patients achieve faster recovery and long-term relief.

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