Materiały źródłowe

• #1 Rectocele – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK546689/

  Rectoceles are a type of pelvic organ prolapse where the rectal tissue herniates through a defect in the rectovaginal septum into the vaginal lumen. […] Rectocele is a variety of pelvic organ prolapse (POP) that involves the herniation of the rectum through the rectovaginal septum into the posterior vaginal lumen. […] The loss of integrity in the rectovaginal fascia would result in a herniation of the rectal tissue into the vaginal lumen, and vice versa, leading to a vaginal bulge along the posterior vaginal wall on examination that would become more pronounced with the Valsalva maneuver. […] A rectocele occurs when healthy rectovaginal septal tissue loses integrity, and the rectum herniates through into the vaginal lumen. Loss of integrity can happen in a variety of ways, including childbirth, age-related connective tissue changes, and increased stress on the tissue through straining or obesity.

• #2 Rectocele – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/sites/books/NBK546689/

  Rectoceles are a type of pelvic organ prolapse where the rectal tissue herniates through a defect in the rectovaginal septum into the vaginal lumen. […] Rectocele is a variety of pelvic organ prolapse (POP) that involves the herniation of the rectum through the rectovaginal septum into the posterior vaginal lumen. […] The loss of integrity in the rectovaginal fascia would result in a herniation of the rectal tissue into the vaginal lumen, and vice versa, leading to a vaginal bulge along the posterior vaginal wall on examination that would become more pronounced with the Valsalva maneuver. […] A rectocele occurs when healthy rectovaginal septal tissue loses integrity, and the rectum herniates through into the vaginal lumen. Loss of integrity can happen in a variety of ways, including childbirth, age-related connective tissue changes, and increased stress on the tissue through straining or obesity.

• #3 Rectocele – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK546689/

  Rectoceles are a type of pelvic organ prolapse where the rectal tissue herniates through a defect in the rectovaginal septum into the vaginal lumen. […] Rectocele is a variety of pelvic organ prolapse (POP) that involves the herniation of the rectum through the rectovaginal septum into the posterior vaginal lumen. […] The loss of integrity in the rectovaginal fascia would result in a herniation of the rectal tissue into the vaginal lumen, and vice versa, leading to a vaginal bulge along the posterior vaginal wall on examination that would become more pronounced with the Valsalva maneuver. […] A rectocele occurs when healthy rectovaginal septal tissue loses integrity, and the rectum herniates through into the vaginal lumen. Loss of integrity can happen in a variety of ways, including childbirth, age-related connective tissue changes, and increased stress on the tissue through straining or obesity.

• #4 Rectocele – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK546689/

  The posterior vaginal wall is supported by uterosacral ligament complex superiorly, levator ani muscles in the middle, and by the endopelvic fascia in the lower segments. The rectovaginal septum is attached to the endopelvic fascia at the level of the perineal body and runs between the vagina and rectum. The loss of integrity in this septum would result in a herniation of the rectal tissue into the vaginal lumen resulting in a vaginal bulge on examination. […] Many factors play a role in the loss of integrity of the rectovaginal septum, including non-modifiable and modifiable factors. […] Age, BMI, parity, and vaginal delivery are the most well-documented risk factors.

• #5 Rectocele – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/sites/books/NBK546689/

  The management of this condition largely depends on the extent of the prolapse and the severity of the symptoms. Management options include lifestyle changes, medications, pessaries, and surgery. […] The posterior vaginal wall is supported by uterosacral ligament complex superiorly, levator ani muscles in the middle, and by the endopelvic fascia in the lower segments. The rectovaginal septum is attached to the endopelvic fascia at the level of the perineal body and runs between the vagina and rectum. The loss of integrity in this septum would result in a herniation of the rectal tissue into the vaginal lumen resulting in a vaginal bulge on examination. […] Many factors play a role in the loss of integrity of the rectovaginal septum, including non-modifiable and modifiable factors. […] A patient may have one or many of these issues, as they can be additive. […] The most common findings of rectocele when symptomatic are a vaginal bulge from the herniation of tissue, pelvic pressure, and changes in defecation.

• #6 Rectocele: Practice Essentials, History of the Procedure, Epidemiology

  https://emedicine.medscape.com/article/268546-overview

  Rectocele is a defect of the rectovaginal septum, not the rectum. The pelvic surgeon must know the anatomy of the pelvic floor and the other supports of the vagina in order to diagnose and treat this disorder. […] The thin membranous connective tissue in the rectovaginal septum (and surrounding the entire vaginal tube) is called the Denonvilliers aponeurosis (fascia) or endopelvic fascia and is fused to the underside of the posterior vaginal wall. […] The perineal body is located between the vaginal introitus and anus. It is the attachment for the perineal membrane, a portion of the levator ani, the external anal sphincter, and the rectovaginal (endopelvic) fascia. […] However, if this attachment is separated, as can occur during childbirth, the perineal body can become more mobile, leading to rectocele and perineal descent.

• #7 Rectocele: Practice Essentials, History of the Procedure, Epidemiology

  https://emedicine.medscape.com/article/268546-overview

  Rectocele is a defect of the rectovaginal septum, not the rectum. The pelvic surgeon must know the anatomy of the pelvic floor and the other supports of the vagina in order to diagnose and treat this disorder. […] The thin membranous connective tissue in the rectovaginal septum (and surrounding the entire vaginal tube) is called the Denonvilliers aponeurosis (fascia) or endopelvic fascia and is fused to the underside of the posterior vaginal wall. […] The perineal body is located between the vaginal introitus and anus. It is the attachment for the perineal membrane, a portion of the levator ani, the external anal sphincter, and the rectovaginal (endopelvic) fascia. […] However, if this attachment is separated, as can occur during childbirth, the perineal body can become more mobile, leading to rectocele and perineal descent.

• #8 The Pathophysiology, Diagnosis, and Management of Rectoceles | GLOWM

  https://www.glowm.com/section-view/heading/The-Pathophysiology-Diagnosis-and-Management-of-Rectoceles/item/58

  A rectocele is an outpocketing of the anterior rectal and posterior vaginal wall into the lumen of the vagina. Some rectoceles may be asymptomatic, whereas others may cause symptoms of incomplete bowel emptying, vaginal mass, pain, and pressure. The incidence of rectoceles is 20-80% in the general population and is thought to be increasing. A rectocele is fundamentally a defect of the rectovaginal septum, not of the rectum. The size of the defect does not correlate with the amount of functional derangement. […] The most common causes of rectoceles are obstetric events. Traumatic obstetric events, which usually occur when the presenting part descends quickly in the second stage of labor, can predispose to rectocele formation. The forces of labor may separate, tear, or distend the pelvic floor, altering the functional and anatomic position of the muscles, nerves, and connective tissues. The rectal fascia may separate from the perineal body, causing a transverse defect and low rectocele. Low rectoceles are an isolated defect in the suprasphincteric portion of the rectovaginal fascia.

• #9 The Pathophysiology, Diagnosis, and Management of Rectoceles | GLOWM

  https://www.glowm.com/section-view/heading/The%20Pathophysiology,%20Diagnosis,%20and%20Management%20of%20Rectoceles/item/58

  A rectocele is fundamentally a defect of the rectovaginal septum, not of the rectum. […] The most common causes of rectoceles are obstetric events. Traumatic obstetric events, which usually occur when the presenting part descends quickly in the second stage of labor, can predispose to rectocele formation. […] Midvaginal rectoceles most likely are caused by obstetric trauma not involving the levator ani. The rectovaginal fascia is damaged by the stretching and laceration of the tissue, which results in thinning of the fascia, leading to subsequent adhesion formation. […] High rectoceles often occur from pathologic overstretching of the posterior vaginal wall. […] Rectoceles may result secondarily from pathologic stretching of the pudendal nerves during descent of the fetal head, causing atrophy and denervation of the pelvic floor muscles. […] Defecation disorders may cause a subgroup of rectoceles. […] Congenital absence of the perineum may mimic a rectocele. […] Some studies have observed differences in connective tissue strengths between races, which may contribute to rectoceles.

• #10 Rectocele | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/rectocele

  Some of the causes of a rectocele include vaginal childbirth, hysterectomy, pelvic surgery and chronic constipation. […] A rectocele occurs when the rectum pushes the back wall of the vagina forward, causing a prominent bulge into the vagina. […] The front wall of the rectum and rear wall of the vagina, and the thin layer of tissue between them, are together called the rectovaginal septum (or wall). This wall can become weak or stretched by pressure such as childbirth, straining while going to the toilet, or ageing. A weak or thinned rectovaginal septum allows the front wall of the rectum to bulge into the vagina. […] Some of the events that may weaken or thin the rectovaginal septum and cause a rectocele include vaginal (normal) childbirth, giving birth to multiple babies, a long and difficult labour, assisted delivery during childbirth, including the use of forceps, tearing during childbirth, particularly if the tear extended from the vagina to the anus, episiotomy, hysterectomy, pelvic surgery, chronic constipation, straining to pass bowel motions, and advancing age, as older women are more prone to rectocele.

• #11 Posterior vaginal prolapse (rectocele) | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/posterior-vaginal-prolapse-rectocele?content_id=CON-20314570

  A posterior vaginal prolapse, also known as a rectocele, occurs when the wall of tissue that separates the rectum from the vagina weakens or tears. […] Childbirth-related tears, chronic straining to pass stool (constipation) and other activities that put pressure on pelvic tissues can lead to posterior vaginal prolapse. […] Posterior vaginal prolapse results from pressure on the pelvic floor or trauma. Causes of increased pelvic floor pressure include: Birth-related tears, Forceps or operative vaginal deliveries, Long-lasting constipation or straining with bowel movements, Long-lasting cough or bronchitis, Repeated heavy lifting, Being overweight. […] The muscles, ligaments and connective tissue that support the vagina stretch during pregnancy, labor and delivery. This can make those tissues weaker and less supportive. The more pregnancies you have, the greater your chance of developing posterior vaginal prolapse.

• #12 Posterior vaginal prolapse (rectocele) // Middlesex Health

  https://middlesexhealth.org/learning-center/diseases-and-conditions/posterior-vaginal-prolapse-rectocele

  A posterior vaginal prolapse, also known as a rectocele, occurs when the wall of tissue that separates the rectum from the vagina weakens or tears. […] Posterior vaginal prolapse results from pressure on the pelvic floor or trauma. […] The muscles, ligaments and connective tissue that support the vagina stretch during pregnancy, labor and delivery. This can make those tissues weaker and less supportive. […] Having vaginally delivered more than one child increases the risk of developing posterior vaginal prolapse. […] Surgery to fix the prolapse might be needed if pelvic floor strengthening exercises or using a pessary doesn’t control your prolapse symptoms well enough. […] Surgery often involves removing extra, stretched tissue that forms the vaginal bulge.

• #13 Rectocele – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK546689/

  The posterior vaginal wall is supported by uterosacral ligament complex superiorly, levator ani muscles in the middle, and by the endopelvic fascia in the lower segments. The rectovaginal septum is attached to the endopelvic fascia at the level of the perineal body and runs between the vagina and rectum. The loss of integrity in this septum would result in a herniation of the rectal tissue into the vaginal lumen resulting in a vaginal bulge on examination. […] Many factors play a role in the loss of integrity of the rectovaginal septum, including non-modifiable and modifiable factors. […] Age, BMI, parity, and vaginal delivery are the most well-documented risk factors.

• #14 Rectocele – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/sites/books/NBK546689/

  The management of this condition largely depends on the extent of the prolapse and the severity of the symptoms. Management options include lifestyle changes, medications, pessaries, and surgery. […] The posterior vaginal wall is supported by uterosacral ligament complex superiorly, levator ani muscles in the middle, and by the endopelvic fascia in the lower segments. The rectovaginal septum is attached to the endopelvic fascia at the level of the perineal body and runs between the vagina and rectum. The loss of integrity in this septum would result in a herniation of the rectal tissue into the vaginal lumen resulting in a vaginal bulge on examination. […] Many factors play a role in the loss of integrity of the rectovaginal septum, including non-modifiable and modifiable factors. […] A patient may have one or many of these issues, as they can be additive. […] The most common findings of rectocele when symptomatic are a vaginal bulge from the herniation of tissue, pelvic pressure, and changes in defecation.

• #15 The Pathophysiology, Diagnosis, and Management of Rectoceles | GLOWM

  https://www.glowm.com/section-view/heading/The-Pathophysiology-Diagnosis-and-Management-of-Rectoceles/item/58

  A rectocele is an outpocketing of the anterior rectal and posterior vaginal wall into the lumen of the vagina. Some rectoceles may be asymptomatic, whereas others may cause symptoms of incomplete bowel emptying, vaginal mass, pain, and pressure. The incidence of rectoceles is 20-80% in the general population and is thought to be increasing. A rectocele is fundamentally a defect of the rectovaginal septum, not of the rectum. The size of the defect does not correlate with the amount of functional derangement. […] The most common causes of rectoceles are obstetric events. Traumatic obstetric events, which usually occur when the presenting part descends quickly in the second stage of labor, can predispose to rectocele formation. The forces of labor may separate, tear, or distend the pelvic floor, altering the functional and anatomic position of the muscles, nerves, and connective tissues. The rectal fascia may separate from the perineal body, causing a transverse defect and low rectocele. Low rectoceles are an isolated defect in the suprasphincteric portion of the rectovaginal fascia.

• #16 The Pathophysiology, Diagnosis, and Management of Rectoceles | GLOWM

  https://www.glowm.com/section-view/heading/The-Pathophysiology-Diagnosis-and-Management-of-Rectoceles/item/58

  A rectocele is an outpocketing of the anterior rectal and posterior vaginal wall into the lumen of the vagina. Some rectoceles may be asymptomatic, whereas others may cause symptoms of incomplete bowel emptying, vaginal mass, pain, and pressure. The incidence of rectoceles is 20-80% in the general population and is thought to be increasing. A rectocele is fundamentally a defect of the rectovaginal septum, not of the rectum. The size of the defect does not correlate with the amount of functional derangement. […] The most common causes of rectoceles are obstetric events. Traumatic obstetric events, which usually occur when the presenting part descends quickly in the second stage of labor, can predispose to rectocele formation. The forces of labor may separate, tear, or distend the pelvic floor, altering the functional and anatomic position of the muscles, nerves, and connective tissues. The rectal fascia may separate from the perineal body, causing a transverse defect and low rectocele. Low rectoceles are an isolated defect in the suprasphincteric portion of the rectovaginal fascia.

• #17 The Pathophysiology, Diagnosis, and Management of Rectoceles | GLOWM

  https://www.glowm.com/section-view/heading/The%20Pathophysiology,%20Diagnosis,%20and%20Management%20of%20Rectoceles/item/58

  A rectocele is fundamentally a defect of the rectovaginal septum, not of the rectum. […] The most common causes of rectoceles are obstetric events. Traumatic obstetric events, which usually occur when the presenting part descends quickly in the second stage of labor, can predispose to rectocele formation. […] Midvaginal rectoceles most likely are caused by obstetric trauma not involving the levator ani. The rectovaginal fascia is damaged by the stretching and laceration of the tissue, which results in thinning of the fascia, leading to subsequent adhesion formation. […] High rectoceles often occur from pathologic overstretching of the posterior vaginal wall. […] Rectoceles may result secondarily from pathologic stretching of the pudendal nerves during descent of the fetal head, causing atrophy and denervation of the pelvic floor muscles. […] Defecation disorders may cause a subgroup of rectoceles. […] Congenital absence of the perineum may mimic a rectocele. […] Some studies have observed differences in connective tissue strengths between races, which may contribute to rectoceles.

• #18 The Pathophysiology, Diagnosis, and Management of Rectoceles | GLOWM

  https://www.glowm.com/section-view/heading/The-Pathophysiology-Diagnosis-and-Management-of-Rectoceles/item/58

  A rectocele is an outpocketing of the anterior rectal and posterior vaginal wall into the lumen of the vagina. Some rectoceles may be asymptomatic, whereas others may cause symptoms of incomplete bowel emptying, vaginal mass, pain, and pressure. The incidence of rectoceles is 20-80% in the general population and is thought to be increasing. A rectocele is fundamentally a defect of the rectovaginal septum, not of the rectum. The size of the defect does not correlate with the amount of functional derangement. […] The most common causes of rectoceles are obstetric events. Traumatic obstetric events, which usually occur when the presenting part descends quickly in the second stage of labor, can predispose to rectocele formation. The forces of labor may separate, tear, or distend the pelvic floor, altering the functional and anatomic position of the muscles, nerves, and connective tissues. The rectal fascia may separate from the perineal body, causing a transverse defect and low rectocele. Low rectoceles are an isolated defect in the suprasphincteric portion of the rectovaginal fascia.

• #19 The Pathophysiology, Diagnosis, and Management of Rectoceles | GLOWM

  https://www.glowm.com/section-view/heading/The-Pathophysiology-Diagnosis-and-Management-of-Rectoceles/item/58

  A rectocele is an outpocketing of the anterior rectal and posterior vaginal wall into the lumen of the vagina. Some rectoceles may be asymptomatic, whereas others may cause symptoms of incomplete bowel emptying, vaginal mass, pain, and pressure. The incidence of rectoceles is 20-80% in the general population and is thought to be increasing. A rectocele is fundamentally a defect of the rectovaginal septum, not of the rectum. The size of the defect does not correlate with the amount of functional derangement. […] The most common causes of rectoceles are obstetric events. Traumatic obstetric events, which usually occur when the presenting part descends quickly in the second stage of labor, can predispose to rectocele formation. The forces of labor may separate, tear, or distend the pelvic floor, altering the functional and anatomic position of the muscles, nerves, and connective tissues. The rectal fascia may separate from the perineal body, causing a transverse defect and low rectocele. Low rectoceles are an isolated defect in the suprasphincteric portion of the rectovaginal fascia.

• #20 The Pathophysiology, Diagnosis, and Management of Rectoceles | GLOWM

  https://www.glowm.com/section-view/heading/The-Pathophysiology-Diagnosis-and-Management-of-Rectoceles/item/58

  A rectocele is an outpocketing of the anterior rectal and posterior vaginal wall into the lumen of the vagina. Some rectoceles may be asymptomatic, whereas others may cause symptoms of incomplete bowel emptying, vaginal mass, pain, and pressure. The incidence of rectoceles is 20-80% in the general population and is thought to be increasing. A rectocele is fundamentally a defect of the rectovaginal septum, not of the rectum. The size of the defect does not correlate with the amount of functional derangement. […] The most common causes of rectoceles are obstetric events. Traumatic obstetric events, which usually occur when the presenting part descends quickly in the second stage of labor, can predispose to rectocele formation. The forces of labor may separate, tear, or distend the pelvic floor, altering the functional and anatomic position of the muscles, nerves, and connective tissues. The rectal fascia may separate from the perineal body, causing a transverse defect and low rectocele. Low rectoceles are an isolated defect in the suprasphincteric portion of the rectovaginal fascia.

• #21 The Pathophysiology, Diagnosis, and Management of Rectoceles | GLOWM

  https://www.glowm.com/section-view/heading/The-Pathophysiology-Diagnosis-and-Management-of-Rectoceles/item/58

  Midvaginal rectoceles most likely are caused by obstetric trauma not involving the levator ani. The rectovaginal fascia is damaged by the stretching and laceration of the tissue, which results in thinning of the fascia, leading to subsequent adhesion formation. This adhesion of the rectovaginal septum, vagina, and rectal capsule inhibits independent function. […] High rectoceles often occur from pathologic overstretching of the posterior vaginal wall. The cardinal ligaments fuse with the vagina and cervix, causing the cervix to fuse with the anterior vaginal wall. The rectovaginal septum is absent from the posterior vaginal wall, causing loss of the anterior rectal wall support. […] Rectoceles may result secondarily from pathologic stretching of the pudendal nerves during descent of the fetal head, causing atrophy and denervation of the pelvic floor muscles.

• #22 The Pathophysiology, Diagnosis, and Management of Rectoceles | GLOWM

  https://www.glowm.com/section-view/heading/The-Pathophysiology-Diagnosis-and-Management-of-Rectoceles/item/58

  A rectocele is an outpocketing of the anterior rectal and posterior vaginal wall into the lumen of the vagina. Some rectoceles may be asymptomatic, whereas others may cause symptoms of incomplete bowel emptying, vaginal mass, pain, and pressure. The incidence of rectoceles is 20-80% in the general population and is thought to be increasing. A rectocele is fundamentally a defect of the rectovaginal septum, not of the rectum. The size of the defect does not correlate with the amount of functional derangement. […] The most common causes of rectoceles are obstetric events. Traumatic obstetric events, which usually occur when the presenting part descends quickly in the second stage of labor, can predispose to rectocele formation. The forces of labor may separate, tear, or distend the pelvic floor, altering the functional and anatomic position of the muscles, nerves, and connective tissues. The rectal fascia may separate from the perineal body, causing a transverse defect and low rectocele. Low rectoceles are an isolated defect in the suprasphincteric portion of the rectovaginal fascia.

• #23 The Pathophysiology, Diagnosis, and Management of Rectoceles | GLOWM

  https://www.glowm.com/section-view/heading/The-Pathophysiology-Diagnosis-and-Management-of-Rectoceles/item/58

  Midvaginal rectoceles most likely are caused by obstetric trauma not involving the levator ani. The rectovaginal fascia is damaged by the stretching and laceration of the tissue, which results in thinning of the fascia, leading to subsequent adhesion formation. This adhesion of the rectovaginal septum, vagina, and rectal capsule inhibits independent function. […] High rectoceles often occur from pathologic overstretching of the posterior vaginal wall. The cardinal ligaments fuse with the vagina and cervix, causing the cervix to fuse with the anterior vaginal wall. The rectovaginal septum is absent from the posterior vaginal wall, causing loss of the anterior rectal wall support. […] Rectoceles may result secondarily from pathologic stretching of the pudendal nerves during descent of the fetal head, causing atrophy and denervation of the pelvic floor muscles.

• #24 The Pathophysiology, Diagnosis, and Management of Rectoceles | GLOWM

  https://www.glowm.com/section-view/heading/The%20Pathophysiology,%20Diagnosis,%20and%20Management%20of%20Rectoceles/item/58

  A rectocele is fundamentally a defect of the rectovaginal septum, not of the rectum. […] The most common causes of rectoceles are obstetric events. Traumatic obstetric events, which usually occur when the presenting part descends quickly in the second stage of labor, can predispose to rectocele formation. […] Midvaginal rectoceles most likely are caused by obstetric trauma not involving the levator ani. The rectovaginal fascia is damaged by the stretching and laceration of the tissue, which results in thinning of the fascia, leading to subsequent adhesion formation. […] High rectoceles often occur from pathologic overstretching of the posterior vaginal wall. […] Rectoceles may result secondarily from pathologic stretching of the pudendal nerves during descent of the fetal head, causing atrophy and denervation of the pelvic floor muscles. […] Defecation disorders may cause a subgroup of rectoceles. […] Congenital absence of the perineum may mimic a rectocele. […] Some studies have observed differences in connective tissue strengths between races, which may contribute to rectoceles.

• #25 The Pathophysiology, Diagnosis, and Management of Rectoceles | GLOWM

  https://www.glowm.com/section-view/heading/The-Pathophysiology-Diagnosis-and-Management-of-Rectoceles/item/58

  Midvaginal rectoceles most likely are caused by obstetric trauma not involving the levator ani. The rectovaginal fascia is damaged by the stretching and laceration of the tissue, which results in thinning of the fascia, leading to subsequent adhesion formation. This adhesion of the rectovaginal septum, vagina, and rectal capsule inhibits independent function. […] High rectoceles often occur from pathologic overstretching of the posterior vaginal wall. The cardinal ligaments fuse with the vagina and cervix, causing the cervix to fuse with the anterior vaginal wall. The rectovaginal septum is absent from the posterior vaginal wall, causing loss of the anterior rectal wall support. […] Rectoceles may result secondarily from pathologic stretching of the pudendal nerves during descent of the fetal head, causing atrophy and denervation of the pelvic floor muscles.

• #26 The Pathophysiology, Diagnosis, and Management of Rectoceles | GLOWM

  https://www.glowm.com/section-view/heading/The%20Pathophysiology,%20Diagnosis,%20and%20Management%20of%20Rectoceles/item/58

  A rectocele is fundamentally a defect of the rectovaginal septum, not of the rectum. […] The most common causes of rectoceles are obstetric events. Traumatic obstetric events, which usually occur when the presenting part descends quickly in the second stage of labor, can predispose to rectocele formation. […] Midvaginal rectoceles most likely are caused by obstetric trauma not involving the levator ani. The rectovaginal fascia is damaged by the stretching and laceration of the tissue, which results in thinning of the fascia, leading to subsequent adhesion formation. […] High rectoceles often occur from pathologic overstretching of the posterior vaginal wall. […] Rectoceles may result secondarily from pathologic stretching of the pudendal nerves during descent of the fetal head, causing atrophy and denervation of the pelvic floor muscles. […] Defecation disorders may cause a subgroup of rectoceles. […] Congenital absence of the perineum may mimic a rectocele. […] Some studies have observed differences in connective tissue strengths between races, which may contribute to rectoceles.

• #27 Rectocele – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK546689/

  Rectoceles are a type of pelvic organ prolapse where the rectal tissue herniates through a defect in the rectovaginal septum into the vaginal lumen. […] Rectocele is a variety of pelvic organ prolapse (POP) that involves the herniation of the rectum through the rectovaginal septum into the posterior vaginal lumen. […] The loss of integrity in the rectovaginal fascia would result in a herniation of the rectal tissue into the vaginal lumen, and vice versa, leading to a vaginal bulge along the posterior vaginal wall on examination that would become more pronounced with the Valsalva maneuver. […] A rectocele occurs when healthy rectovaginal septal tissue loses integrity, and the rectum herniates through into the vaginal lumen. Loss of integrity can happen in a variety of ways, including childbirth, age-related connective tissue changes, and increased stress on the tissue through straining or obesity.

• #28 Posterior vaginal prolapse (rectocele) | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/posterior-vaginal-prolapse-rectocele?content_id=CON-20314570

  A posterior vaginal prolapse, also known as a rectocele, occurs when the wall of tissue that separates the rectum from the vagina weakens or tears. […] Childbirth-related tears, chronic straining to pass stool (constipation) and other activities that put pressure on pelvic tissues can lead to posterior vaginal prolapse. […] Posterior vaginal prolapse results from pressure on the pelvic floor or trauma. Causes of increased pelvic floor pressure include: Birth-related tears, Forceps or operative vaginal deliveries, Long-lasting constipation or straining with bowel movements, Long-lasting cough or bronchitis, Repeated heavy lifting, Being overweight. […] The muscles, ligaments and connective tissue that support the vagina stretch during pregnancy, labor and delivery. This can make those tissues weaker and less supportive. The more pregnancies you have, the greater your chance of developing posterior vaginal prolapse.

• #29 Posterior vaginal prolapse (rectocele) | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/posterior-vaginal-prolapse-rectocele?content_id=CON-20314570

  A posterior vaginal prolapse, also known as a rectocele, occurs when the wall of tissue that separates the rectum from the vagina weakens or tears. […] Childbirth-related tears, chronic straining to pass stool (constipation) and other activities that put pressure on pelvic tissues can lead to posterior vaginal prolapse. […] Posterior vaginal prolapse results from pressure on the pelvic floor or trauma. Causes of increased pelvic floor pressure include: Birth-related tears, Forceps or operative vaginal deliveries, Long-lasting constipation or straining with bowel movements, Long-lasting cough or bronchitis, Repeated heavy lifting, Being overweight. […] The muscles, ligaments and connective tissue that support the vagina stretch during pregnancy, labor and delivery. This can make those tissues weaker and less supportive. The more pregnancies you have, the greater your chance of developing posterior vaginal prolapse.

• #30 Women’s Wellness: Problems with a posterior vaginal prolapse – Mayo Clinic News Network

  https://newsnetwork.mayoclinic.org/discussion/womens-wellness-posterior-vaginal-prolapse-rectocele/

  A posterior vaginal wall prolapse occurs when the thin wall of tissue that separates the rectum from the vagina weakens, allowing the vaginal wall to bulge. Posterior vaginal prolapse is also called a „rectocele”(REK-toe-seel). […] Childbirth and other processes that put pressure on pelvic tissues can lead to posterior vaginal prolapse. […] Posterior vaginal prolapse results from pressure on the pelvic floor. Causes of increased pelvic floor pressure include: Chronic constipation or straining with bowel movements, Chronic cough or bronchitis, Repeated heavy lifting, Being overweight or obese. […] The muscles, ligaments and connective tissue that support your vagina become stretched and weakened during pregnancy, labor and delivery. The more pregnancies you have, the greater your chance of developing posterior vaginal prolapse.

• #31 Posterior vaginal prolapse (rectocele) | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/posterior-vaginal-prolapse-rectocele?content_id=CON-20314570

  A posterior vaginal prolapse, also known as a rectocele, occurs when the wall of tissue that separates the rectum from the vagina weakens or tears. […] Childbirth-related tears, chronic straining to pass stool (constipation) and other activities that put pressure on pelvic tissues can lead to posterior vaginal prolapse. […] Posterior vaginal prolapse results from pressure on the pelvic floor or trauma. Causes of increased pelvic floor pressure include: Birth-related tears, Forceps or operative vaginal deliveries, Long-lasting constipation or straining with bowel movements, Long-lasting cough or bronchitis, Repeated heavy lifting, Being overweight. […] The muscles, ligaments and connective tissue that support the vagina stretch during pregnancy, labor and delivery. This can make those tissues weaker and less supportive. The more pregnancies you have, the greater your chance of developing posterior vaginal prolapse.

• #32 Women’s Wellness: Problems with a posterior vaginal prolapse – Mayo Clinic News Network

  https://newsnetwork.mayoclinic.org/discussion/womens-wellness-posterior-vaginal-prolapse-rectocele/

  A posterior vaginal wall prolapse occurs when the thin wall of tissue that separates the rectum from the vagina weakens, allowing the vaginal wall to bulge. Posterior vaginal prolapse is also called a „rectocele”(REK-toe-seel). […] Childbirth and other processes that put pressure on pelvic tissues can lead to posterior vaginal prolapse. […] Posterior vaginal prolapse results from pressure on the pelvic floor. Causes of increased pelvic floor pressure include: Chronic constipation or straining with bowel movements, Chronic cough or bronchitis, Repeated heavy lifting, Being overweight or obese. […] The muscles, ligaments and connective tissue that support your vagina become stretched and weakened during pregnancy, labor and delivery. The more pregnancies you have, the greater your chance of developing posterior vaginal prolapse.

• #33 The Pathophysiology, Diagnosis, and Management of Rectoceles | GLOWM

  https://www.glowm.com/section-view/heading/The-Pathophysiology-Diagnosis-and-Management-of-Rectoceles/item/58

  A rectocele is an outpocketing of the anterior rectal and posterior vaginal wall into the lumen of the vagina. Some rectoceles may be asymptomatic, whereas others may cause symptoms of incomplete bowel emptying, vaginal mass, pain, and pressure. The incidence of rectoceles is 20-80% in the general population and is thought to be increasing. A rectocele is fundamentally a defect of the rectovaginal septum, not of the rectum. The size of the defect does not correlate with the amount of functional derangement. […] The most common causes of rectoceles are obstetric events. Traumatic obstetric events, which usually occur when the presenting part descends quickly in the second stage of labor, can predispose to rectocele formation. The forces of labor may separate, tear, or distend the pelvic floor, altering the functional and anatomic position of the muscles, nerves, and connective tissues. The rectal fascia may separate from the perineal body, causing a transverse defect and low rectocele. Low rectoceles are an isolated defect in the suprasphincteric portion of the rectovaginal fascia.

• #34 Posterior vaginal prolapse (rectocele) | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/posterior-vaginal-prolapse-rectocele?content_id=CON-20314570

  A posterior vaginal prolapse, also known as a rectocele, occurs when the wall of tissue that separates the rectum from the vagina weakens or tears. […] Childbirth-related tears, chronic straining to pass stool (constipation) and other activities that put pressure on pelvic tissues can lead to posterior vaginal prolapse. […] Posterior vaginal prolapse results from pressure on the pelvic floor or trauma. Causes of increased pelvic floor pressure include: Birth-related tears, Forceps or operative vaginal deliveries, Long-lasting constipation or straining with bowel movements, Long-lasting cough or bronchitis, Repeated heavy lifting, Being overweight. […] The muscles, ligaments and connective tissue that support the vagina stretch during pregnancy, labor and delivery. This can make those tissues weaker and less supportive. The more pregnancies you have, the greater your chance of developing posterior vaginal prolapse.

• #35 Posterior vaginal prolapse (rectocele) | UM Health-Sparrow

  https://www.uofmhealthsparrow.org/departments-conditions/conditions/posterior-vaginal-prolapse-rectocele

  A posterior vaginal prolapse is a bulge of tissue into the vagina. It happens when the tissue between the rectum and the vagina weakens or tears. This causes the rectum to push into the vaginal wall. Posterior vaginal prolapse is also called a rectocele (REK-toe-seel). […] Childbirth-related tears, chronic straining to pass stool (constipation) and other activities that put pressure on pelvic tissues can lead to posterior vaginal prolapse. […] Posterior vaginal prolapse results from pressure on the pelvic floor or trauma. Causes of increased pelvic floor pressure include: Birth-related tears, Forceps or operative vaginal deliveries, Long-lasting constipation or straining with bowel movements, Long-lasting cough or bronchitis, Repeated heavy lifting, Being overweight. […] The muscles, ligaments and connective tissue that support the vagina stretch during pregnancy, labor and delivery. This can make those tissues weaker and less supportive. The more pregnancies you have, the greater your chance of developing posterior vaginal prolapse.

• #36 Rectocele | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/rectocele

  Some of the causes of a rectocele include vaginal childbirth, hysterectomy, pelvic surgery and chronic constipation. […] A rectocele occurs when the rectum pushes the back wall of the vagina forward, causing a prominent bulge into the vagina. […] The front wall of the rectum and rear wall of the vagina, and the thin layer of tissue between them, are together called the rectovaginal septum (or wall). This wall can become weak or stretched by pressure such as childbirth, straining while going to the toilet, or ageing. A weak or thinned rectovaginal septum allows the front wall of the rectum to bulge into the vagina. […] Some of the events that may weaken or thin the rectovaginal septum and cause a rectocele include vaginal (normal) childbirth, giving birth to multiple babies, a long and difficult labour, assisted delivery during childbirth, including the use of forceps, tearing during childbirth, particularly if the tear extended from the vagina to the anus, episiotomy, hysterectomy, pelvic surgery, chronic constipation, straining to pass bowel motions, and advancing age, as older women are more prone to rectocele.

• #37 Posterior vaginal prolapse (rectocele) | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/posterior-vaginal-prolapse-rectocele?content_id=CON-20314570

  A posterior vaginal prolapse, also known as a rectocele, occurs when the wall of tissue that separates the rectum from the vagina weakens or tears. […] Childbirth-related tears, chronic straining to pass stool (constipation) and other activities that put pressure on pelvic tissues can lead to posterior vaginal prolapse. […] Posterior vaginal prolapse results from pressure on the pelvic floor or trauma. Causes of increased pelvic floor pressure include: Birth-related tears, Forceps or operative vaginal deliveries, Long-lasting constipation or straining with bowel movements, Long-lasting cough or bronchitis, Repeated heavy lifting, Being overweight. […] The muscles, ligaments and connective tissue that support the vagina stretch during pregnancy, labor and delivery. This can make those tissues weaker and less supportive. The more pregnancies you have, the greater your chance of developing posterior vaginal prolapse.

• #38 Posterior vaginal prolapse (rectocele) | UM Health-Sparrow

  https://www.uofmhealthsparrow.org/departments-conditions/conditions/posterior-vaginal-prolapse-rectocele

  A posterior vaginal prolapse is a bulge of tissue into the vagina. It happens when the tissue between the rectum and the vagina weakens or tears. This causes the rectum to push into the vaginal wall. Posterior vaginal prolapse is also called a rectocele (REK-toe-seel). […] Childbirth-related tears, chronic straining to pass stool (constipation) and other activities that put pressure on pelvic tissues can lead to posterior vaginal prolapse. […] Posterior vaginal prolapse results from pressure on the pelvic floor or trauma. Causes of increased pelvic floor pressure include: Birth-related tears, Forceps or operative vaginal deliveries, Long-lasting constipation or straining with bowel movements, Long-lasting cough or bronchitis, Repeated heavy lifting, Being overweight. […] The muscles, ligaments and connective tissue that support the vagina stretch during pregnancy, labor and delivery. This can make those tissues weaker and less supportive. The more pregnancies you have, the greater your chance of developing posterior vaginal prolapse.

• #39 Rectocele: Causes, Symptoms, Diagnosis, Stages & Treatment

  https://my.clevelandclinic.org/health/diseases/17415-rectocele

  A rectocele is a condition where the tissue between your rectum and vagina weakens, causing your rectum to bulge onto your vagina’s back wall. […] Rectocele is one form of pelvic organ prolapse (POP), a condition where organs droop because of a weak pelvic floor. […] A rectocele occurs when your pelvic floor weakens. Several factors can contribute: […] A surgical procedure called posterior colporrhaphy is commonly used to repair rectoceles. […] A rectocele occurs because of injury or long-term weakening of your pelvic floor. It doesn’t heal on its own without treatment. […] Rectocele can worsen without treatment.

• #40 Posterior vaginal prolapse (rectocele) | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/posterior-vaginal-prolapse-rectocele?content_id=CON-20314570

  A posterior vaginal prolapse, also known as a rectocele, occurs when the wall of tissue that separates the rectum from the vagina weakens or tears. […] Childbirth-related tears, chronic straining to pass stool (constipation) and other activities that put pressure on pelvic tissues can lead to posterior vaginal prolapse. […] Posterior vaginal prolapse results from pressure on the pelvic floor or trauma. Causes of increased pelvic floor pressure include: Birth-related tears, Forceps or operative vaginal deliveries, Long-lasting constipation or straining with bowel movements, Long-lasting cough or bronchitis, Repeated heavy lifting, Being overweight. […] The muscles, ligaments and connective tissue that support the vagina stretch during pregnancy, labor and delivery. This can make those tissues weaker and less supportive. The more pregnancies you have, the greater your chance of developing posterior vaginal prolapse.

• #41 Posterior vaginal prolapse (rectocele) | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/posterior-vaginal-prolapse-rectocele?content_id=CON-20314570

  A posterior vaginal prolapse, also known as a rectocele, occurs when the wall of tissue that separates the rectum from the vagina weakens or tears. […] Childbirth-related tears, chronic straining to pass stool (constipation) and other activities that put pressure on pelvic tissues can lead to posterior vaginal prolapse. […] Posterior vaginal prolapse results from pressure on the pelvic floor or trauma. Causes of increased pelvic floor pressure include: Birth-related tears, Forceps or operative vaginal deliveries, Long-lasting constipation or straining with bowel movements, Long-lasting cough or bronchitis, Repeated heavy lifting, Being overweight. […] The muscles, ligaments and connective tissue that support the vagina stretch during pregnancy, labor and delivery. This can make those tissues weaker and less supportive. The more pregnancies you have, the greater your chance of developing posterior vaginal prolapse.

• #42 Women’s Wellness: Problems with a posterior vaginal prolapse – Mayo Clinic News Network

  https://newsnetwork.mayoclinic.org/discussion/womens-wellness-posterior-vaginal-prolapse-rectocele/

  A posterior vaginal wall prolapse occurs when the thin wall of tissue that separates the rectum from the vagina weakens, allowing the vaginal wall to bulge. Posterior vaginal prolapse is also called a „rectocele”(REK-toe-seel). […] Childbirth and other processes that put pressure on pelvic tissues can lead to posterior vaginal prolapse. […] Posterior vaginal prolapse results from pressure on the pelvic floor. Causes of increased pelvic floor pressure include: Chronic constipation or straining with bowel movements, Chronic cough or bronchitis, Repeated heavy lifting, Being overweight or obese. […] The muscles, ligaments and connective tissue that support your vagina become stretched and weakened during pregnancy, labor and delivery. The more pregnancies you have, the greater your chance of developing posterior vaginal prolapse.

• #43 The Pathophysiology, Diagnosis, and Management of Rectoceles | GLOWM

  https://www.glowm.com/section-view/heading/The-Pathophysiology-Diagnosis-and-Management-of-Rectoceles/item/58

  Defecation disorders may cause a subgroup of rectoceles. These disorders may lead to the weakening of the rectovaginal septum by continuous straining against an obstruction. […] Congenital absence of the perineum may mimic a rectocele. This pseudorectocele has its posterior vaginal wall exposed because of the lack of inferior support. […] Some studies have observed differences in connective tissue strengths between races, which may contribute to rectoceles.

• #44 The Pathophysiology, Diagnosis, and Management of Rectoceles | GLOWM

  https://www.glowm.com/section-view/heading/The%20Pathophysiology,%20Diagnosis,%20and%20Management%20of%20Rectoceles/item/58

  A rectocele is fundamentally a defect of the rectovaginal septum, not of the rectum. […] The most common causes of rectoceles are obstetric events. Traumatic obstetric events, which usually occur when the presenting part descends quickly in the second stage of labor, can predispose to rectocele formation. […] Midvaginal rectoceles most likely are caused by obstetric trauma not involving the levator ani. The rectovaginal fascia is damaged by the stretching and laceration of the tissue, which results in thinning of the fascia, leading to subsequent adhesion formation. […] High rectoceles often occur from pathologic overstretching of the posterior vaginal wall. […] Rectoceles may result secondarily from pathologic stretching of the pudendal nerves during descent of the fetal head, causing atrophy and denervation of the pelvic floor muscles. […] Defecation disorders may cause a subgroup of rectoceles. […] Congenital absence of the perineum may mimic a rectocele. […] Some studies have observed differences in connective tissue strengths between races, which may contribute to rectoceles.

• #45 Posterior vaginal prolapse (rectocele) | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/posterior-vaginal-prolapse-rectocele?content_id=CON-20314570

  A posterior vaginal prolapse, also known as a rectocele, occurs when the wall of tissue that separates the rectum from the vagina weakens or tears. […] Childbirth-related tears, chronic straining to pass stool (constipation) and other activities that put pressure on pelvic tissues can lead to posterior vaginal prolapse. […] Posterior vaginal prolapse results from pressure on the pelvic floor or trauma. Causes of increased pelvic floor pressure include: Birth-related tears, Forceps or operative vaginal deliveries, Long-lasting constipation or straining with bowel movements, Long-lasting cough or bronchitis, Repeated heavy lifting, Being overweight. […] The muscles, ligaments and connective tissue that support the vagina stretch during pregnancy, labor and delivery. This can make those tissues weaker and less supportive. The more pregnancies you have, the greater your chance of developing posterior vaginal prolapse.

• #46 Women’s Wellness: Problems with a posterior vaginal prolapse – Mayo Clinic News Network

  https://newsnetwork.mayoclinic.org/discussion/womens-wellness-posterior-vaginal-prolapse-rectocele/

  A posterior vaginal wall prolapse occurs when the thin wall of tissue that separates the rectum from the vagina weakens, allowing the vaginal wall to bulge. Posterior vaginal prolapse is also called a „rectocele”(REK-toe-seel). […] Childbirth and other processes that put pressure on pelvic tissues can lead to posterior vaginal prolapse. […] Posterior vaginal prolapse results from pressure on the pelvic floor. Causes of increased pelvic floor pressure include: Chronic constipation or straining with bowel movements, Chronic cough or bronchitis, Repeated heavy lifting, Being overweight or obese. […] The muscles, ligaments and connective tissue that support your vagina become stretched and weakened during pregnancy, labor and delivery. The more pregnancies you have, the greater your chance of developing posterior vaginal prolapse.

• #47 Posterior vaginal prolapse (rectocele) | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/posterior-vaginal-prolapse-rectocele?content_id=CON-20314570

  A posterior vaginal prolapse, also known as a rectocele, occurs when the wall of tissue that separates the rectum from the vagina weakens or tears. […] Childbirth-related tears, chronic straining to pass stool (constipation) and other activities that put pressure on pelvic tissues can lead to posterior vaginal prolapse. […] Posterior vaginal prolapse results from pressure on the pelvic floor or trauma. Causes of increased pelvic floor pressure include: Birth-related tears, Forceps or operative vaginal deliveries, Long-lasting constipation or straining with bowel movements, Long-lasting cough or bronchitis, Repeated heavy lifting, Being overweight. […] The muscles, ligaments and connective tissue that support the vagina stretch during pregnancy, labor and delivery. This can make those tissues weaker and less supportive. The more pregnancies you have, the greater your chance of developing posterior vaginal prolapse.

• #48 Women’s Wellness: Problems with a posterior vaginal prolapse – Mayo Clinic News Network

  https://newsnetwork.mayoclinic.org/discussion/womens-wellness-posterior-vaginal-prolapse-rectocele/

  A posterior vaginal wall prolapse occurs when the thin wall of tissue that separates the rectum from the vagina weakens, allowing the vaginal wall to bulge. Posterior vaginal prolapse is also called a „rectocele”(REK-toe-seel). […] Childbirth and other processes that put pressure on pelvic tissues can lead to posterior vaginal prolapse. […] Posterior vaginal prolapse results from pressure on the pelvic floor. Causes of increased pelvic floor pressure include: Chronic constipation or straining with bowel movements, Chronic cough or bronchitis, Repeated heavy lifting, Being overweight or obese. […] The muscles, ligaments and connective tissue that support your vagina become stretched and weakened during pregnancy, labor and delivery. The more pregnancies you have, the greater your chance of developing posterior vaginal prolapse.

• #49 Posterior vaginal prolapse (rectocele) | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/posterior-vaginal-prolapse-rectocele?content_id=CON-20314570

  Some people are born with weaker connective tissues in the pelvic area. This makes them naturally more likely to develop posterior vaginal prolapse. […] Having vaginally delivered more than one child increases the risk of developing posterior vaginal prolapse. […] Surgery to fix the prolapse might be needed if: Pelvic floor strengthening exercises or using a pessary doesn’t control your prolapse symptoms well enough. […] Surgery often involves removing extra, stretched tissue that forms the vaginal bulge. Then stitches are placed to support pelvic structures.

• #50 Women’s Wellness: Problems with a posterior vaginal prolapse – Mayo Clinic News Network

  https://newsnetwork.mayoclinic.org/discussion/womens-wellness-posterior-vaginal-prolapse-rectocele/

  Factors that may increase your risk of posterior vaginal prolapse include: Genetics Some women are born with weaker connective tissues in the pelvic area, making them naturally more likely to develop posterior vaginal prolapse. Childbirth If you have vaginally delivered multiple children, you have a higher risk of developing posterior vaginal prolapse.

• #51 Posterior vaginal prolapse (rectocele) | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/posterior-vaginal-prolapse-rectocele?content_id=CON-20314570

  Some people are born with weaker connective tissues in the pelvic area. This makes them naturally more likely to develop posterior vaginal prolapse. […] Having vaginally delivered more than one child increases the risk of developing posterior vaginal prolapse. […] Surgery to fix the prolapse might be needed if: Pelvic floor strengthening exercises or using a pessary doesn’t control your prolapse symptoms well enough. […] Surgery often involves removing extra, stretched tissue that forms the vaginal bulge. Then stitches are placed to support pelvic structures.

• #52 Women’s Wellness: Problems with a posterior vaginal prolapse – Mayo Clinic News Network

  https://newsnetwork.mayoclinic.org/discussion/womens-wellness-posterior-vaginal-prolapse-rectocele/

  Factors that may increase your risk of posterior vaginal prolapse include: Genetics Some women are born with weaker connective tissues in the pelvic area, making them naturally more likely to develop posterior vaginal prolapse. Childbirth If you have vaginally delivered multiple children, you have a higher risk of developing posterior vaginal prolapse.

• #53 Posterior vaginal prolapse (rectocele) | Altru Health System

  https://www.altru.org/health-library/conditions/posterior-vaginal-prolapse-rectocele

  Some people are born with weaker connective tissues in the pelvic area. This makes them naturally more likely to develop posterior vaginal prolapse. […] Having vaginally delivered more than one child increases the risk of developing posterior vaginal prolapse. […] Growing older causes loss of muscle mass, elasticity and nerve function, which causes muscles to stretch or weaken. […] Extra body weight places stress on pelvic floor tissues. […] Kegel exercises strengthen pelvic floor muscles. A strong pelvic floor provides better support for pelvic organs. It also might relieve bulge symptoms that posterior vaginal prolapse can cause.

• #54 Rectocele – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK546689/

  Rectoceles are a type of pelvic organ prolapse where the rectal tissue herniates through a defect in the rectovaginal septum into the vaginal lumen. […] Rectocele is a variety of pelvic organ prolapse (POP) that involves the herniation of the rectum through the rectovaginal septum into the posterior vaginal lumen. […] The loss of integrity in the rectovaginal fascia would result in a herniation of the rectal tissue into the vaginal lumen, and vice versa, leading to a vaginal bulge along the posterior vaginal wall on examination that would become more pronounced with the Valsalva maneuver. […] A rectocele occurs when healthy rectovaginal septal tissue loses integrity, and the rectum herniates through into the vaginal lumen. Loss of integrity can happen in a variety of ways, including childbirth, age-related connective tissue changes, and increased stress on the tissue through straining or obesity.

• #55 The Pathophysiology, Diagnosis, and Management of Rectoceles | GLOWM

  https://www.glowm.com/section-view/heading/The-Pathophysiology-Diagnosis-and-Management-of-Rectoceles/item/58

  Defecation disorders may cause a subgroup of rectoceles. These disorders may lead to the weakening of the rectovaginal septum by continuous straining against an obstruction. […] Congenital absence of the perineum may mimic a rectocele. This pseudorectocele has its posterior vaginal wall exposed because of the lack of inferior support. […] Some studies have observed differences in connective tissue strengths between races, which may contribute to rectoceles.

• #56 The Pathophysiology, Diagnosis, and Management of Rectoceles | GLOWM

  https://www.glowm.com/section-view/heading/The%20Pathophysiology,%20Diagnosis,%20and%20Management%20of%20Rectoceles/item/58

  A rectocele is fundamentally a defect of the rectovaginal septum, not of the rectum. […] The most common causes of rectoceles are obstetric events. Traumatic obstetric events, which usually occur when the presenting part descends quickly in the second stage of labor, can predispose to rectocele formation. […] Midvaginal rectoceles most likely are caused by obstetric trauma not involving the levator ani. The rectovaginal fascia is damaged by the stretching and laceration of the tissue, which results in thinning of the fascia, leading to subsequent adhesion formation. […] High rectoceles often occur from pathologic overstretching of the posterior vaginal wall. […] Rectoceles may result secondarily from pathologic stretching of the pudendal nerves during descent of the fetal head, causing atrophy and denervation of the pelvic floor muscles. […] Defecation disorders may cause a subgroup of rectoceles. […] Congenital absence of the perineum may mimic a rectocele. […] Some studies have observed differences in connective tissue strengths between races, which may contribute to rectoceles.

• #57 Rectocele: Causes, Symptoms, Diagnosis, Stages & Treatment

  https://my.clevelandclinic.org/health/diseases/17415-rectocele

  A rectocele is a condition where the tissue between your rectum and vagina weakens, causing your rectum to bulge onto your vagina’s back wall. […] Rectocele is one form of pelvic organ prolapse (POP), a condition where organs droop because of a weak pelvic floor. […] A rectocele occurs when your pelvic floor weakens. Several factors can contribute: […] A surgical procedure called posterior colporrhaphy is commonly used to repair rectoceles. […] A rectocele occurs because of injury or long-term weakening of your pelvic floor. It doesn’t heal on its own without treatment. […] Rectocele can worsen without treatment.

• #58 Posterior vaginal prolapse (rectocele) | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/posterior-vaginal-prolapse-rectocele?content_id=CON-20314570

  A posterior vaginal prolapse, also known as a rectocele, occurs when the wall of tissue that separates the rectum from the vagina weakens or tears. […] Childbirth-related tears, chronic straining to pass stool (constipation) and other activities that put pressure on pelvic tissues can lead to posterior vaginal prolapse. […] Posterior vaginal prolapse results from pressure on the pelvic floor or trauma. Causes of increased pelvic floor pressure include: Birth-related tears, Forceps or operative vaginal deliveries, Long-lasting constipation or straining with bowel movements, Long-lasting cough or bronchitis, Repeated heavy lifting, Being overweight. […] The muscles, ligaments and connective tissue that support the vagina stretch during pregnancy, labor and delivery. This can make those tissues weaker and less supportive. The more pregnancies you have, the greater your chance of developing posterior vaginal prolapse.

• #59 Posterior vaginal prolapse (rectocele) | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/posterior-vaginal-prolapse-rectocele?content_id=CON-20314570

  A posterior vaginal prolapse, also known as a rectocele, occurs when the wall of tissue that separates the rectum from the vagina weakens or tears. […] Childbirth-related tears, chronic straining to pass stool (constipation) and other activities that put pressure on pelvic tissues can lead to posterior vaginal prolapse. […] Posterior vaginal prolapse results from pressure on the pelvic floor or trauma. Causes of increased pelvic floor pressure include: Birth-related tears, Forceps or operative vaginal deliveries, Long-lasting constipation or straining with bowel movements, Long-lasting cough or bronchitis, Repeated heavy lifting, Being overweight. […] The muscles, ligaments and connective tissue that support the vagina stretch during pregnancy, labor and delivery. This can make those tissues weaker and less supportive. The more pregnancies you have, the greater your chance of developing posterior vaginal prolapse.

• #60 Posterior vaginal prolapse (rectocele) | Altru Health System

  https://www.altru.org/health-library/conditions/posterior-vaginal-prolapse-rectocele

  Some people are born with weaker connective tissues in the pelvic area. This makes them naturally more likely to develop posterior vaginal prolapse. […] Having vaginally delivered more than one child increases the risk of developing posterior vaginal prolapse. […] Growing older causes loss of muscle mass, elasticity and nerve function, which causes muscles to stretch or weaken. […] Extra body weight places stress on pelvic floor tissues. […] Kegel exercises strengthen pelvic floor muscles. A strong pelvic floor provides better support for pelvic organs. It also might relieve bulge symptoms that posterior vaginal prolapse can cause.

• #61 Rectocele | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/rectocele

  Some of the causes of a rectocele include vaginal childbirth, hysterectomy, pelvic surgery and chronic constipation. […] A rectocele occurs when the rectum pushes the back wall of the vagina forward, causing a prominent bulge into the vagina. […] The front wall of the rectum and rear wall of the vagina, and the thin layer of tissue between them, are together called the rectovaginal septum (or wall). This wall can become weak or stretched by pressure such as childbirth, straining while going to the toilet, or ageing. A weak or thinned rectovaginal septum allows the front wall of the rectum to bulge into the vagina. […] Some of the events that may weaken or thin the rectovaginal septum and cause a rectocele include vaginal (normal) childbirth, giving birth to multiple babies, a long and difficult labour, assisted delivery during childbirth, including the use of forceps, tearing during childbirth, particularly if the tear extended from the vagina to the anus, episiotomy, hysterectomy, pelvic surgery, chronic constipation, straining to pass bowel motions, and advancing age, as older women are more prone to rectocele.

• #62 Rectocele – Wikipedia

  https://en.wikipedia.org/wiki/Rectocele

  In gynecology, a rectocele or posterior vaginal wall prolapse results when the rectum bulges (herniates) into the vagina. Two common causes of this defect are childbirth and hysterectomy. Rectocele also tends to occur with other forms of pelvic organ prolapse, such as enterocele, sigmoidocele and cystocele. […] Rectoceles result from the weakening of the pelvic floor also called pelvic organ prolapse. Weakened pelvic structures occur as a result of an episiotomy during previous births, even decades later. Other causes of pelvic floor prolapse can be advanced age, multiple vaginal deliveries, and birthing trauma. Birthing trauma includes vacuum delivery, forceps delivery, and perineal tear. In addition, a history of chronic constipation and excessive straining with bowel movements are thought to play a role in rectocele. Multiple gynecological or rectal surgeries can also lead to weakening of the pelvic floor. […] A hysterectomy or other pelvic surgery can be a cause, as can chronic constipation and straining to pass bowel movements. It is more common in older women than in younger ones because estrogen which helps to keep the pelvic tissues elastic decreases after menopause.

• #63 The Pathophysiology, Diagnosis, and Management of Rectoceles | GLOWM

  https://www.glowm.com/section-view/heading/The-Pathophysiology-Diagnosis-and-Management-of-Rectoceles/item/58

  Midvaginal rectoceles most likely are caused by obstetric trauma not involving the levator ani. The rectovaginal fascia is damaged by the stretching and laceration of the tissue, which results in thinning of the fascia, leading to subsequent adhesion formation. This adhesion of the rectovaginal septum, vagina, and rectal capsule inhibits independent function. […] High rectoceles often occur from pathologic overstretching of the posterior vaginal wall. The cardinal ligaments fuse with the vagina and cervix, causing the cervix to fuse with the anterior vaginal wall. The rectovaginal septum is absent from the posterior vaginal wall, causing loss of the anterior rectal wall support. […] Rectoceles may result secondarily from pathologic stretching of the pudendal nerves during descent of the fetal head, causing atrophy and denervation of the pelvic floor muscles.

• #64 The Pathophysiology, Diagnosis, and Management of Rectoceles | GLOWM

  https://www.glowm.com/section-view/heading/The%20Pathophysiology,%20Diagnosis,%20and%20Management%20of%20Rectoceles/item/58

  A rectocele is fundamentally a defect of the rectovaginal septum, not of the rectum. […] The most common causes of rectoceles are obstetric events. Traumatic obstetric events, which usually occur when the presenting part descends quickly in the second stage of labor, can predispose to rectocele formation. […] Midvaginal rectoceles most likely are caused by obstetric trauma not involving the levator ani. The rectovaginal fascia is damaged by the stretching and laceration of the tissue, which results in thinning of the fascia, leading to subsequent adhesion formation. […] High rectoceles often occur from pathologic overstretching of the posterior vaginal wall. […] Rectoceles may result secondarily from pathologic stretching of the pudendal nerves during descent of the fetal head, causing atrophy and denervation of the pelvic floor muscles. […] Defecation disorders may cause a subgroup of rectoceles. […] Congenital absence of the perineum may mimic a rectocele. […] Some studies have observed differences in connective tissue strengths between races, which may contribute to rectoceles.

• #65 The Pathophysiology, Diagnosis, and Management of Rectoceles | GLOWM

  https://www.glowm.com/section-view/heading/The-Pathophysiology-Diagnosis-and-Management-of-Rectoceles/item/58

  Defecation disorders may cause a subgroup of rectoceles. These disorders may lead to the weakening of the rectovaginal septum by continuous straining against an obstruction. […] Congenital absence of the perineum may mimic a rectocele. This pseudorectocele has its posterior vaginal wall exposed because of the lack of inferior support. […] Some studies have observed differences in connective tissue strengths between races, which may contribute to rectoceles.

• #66 The Pathophysiology, Diagnosis, and Management of Rectoceles | GLOWM

  https://www.glowm.com/section-view/heading/The%20Pathophysiology,%20Diagnosis,%20and%20Management%20of%20Rectoceles/item/58

  A rectocele is fundamentally a defect of the rectovaginal septum, not of the rectum. […] The most common causes of rectoceles are obstetric events. Traumatic obstetric events, which usually occur when the presenting part descends quickly in the second stage of labor, can predispose to rectocele formation. […] Midvaginal rectoceles most likely are caused by obstetric trauma not involving the levator ani. The rectovaginal fascia is damaged by the stretching and laceration of the tissue, which results in thinning of the fascia, leading to subsequent adhesion formation. […] High rectoceles often occur from pathologic overstretching of the posterior vaginal wall. […] Rectoceles may result secondarily from pathologic stretching of the pudendal nerves during descent of the fetal head, causing atrophy and denervation of the pelvic floor muscles. […] Defecation disorders may cause a subgroup of rectoceles. […] Congenital absence of the perineum may mimic a rectocele. […] Some studies have observed differences in connective tissue strengths between races, which may contribute to rectoceles.

• #67 Surgical management of posterior vaginal defects – UpToDate

  https://www.uptodate.com/contents/surgical-management-of-posterior-vaginal-defects

  INTRODUCTION […] The surgical approach to management of posterior vaginal wall defects (rectocele) will be discussed here. […] Comparisons of the histology of women with and without prolapse have shown that the smooth muscle content of the posterior vaginal wall of women with prolapse is disorganized and significantly reduced compared with women without prolapse [2].

• #68 Rectocele: Practice Essentials, History of the Procedure, Epidemiology

  https://emedicine.medscape.com/article/268546-overview

  Rectocele is a defect of the rectovaginal septum, not the rectum. The pelvic surgeon must know the anatomy of the pelvic floor and the other supports of the vagina in order to diagnose and treat this disorder. […] The thin membranous connective tissue in the rectovaginal septum (and surrounding the entire vaginal tube) is called the Denonvilliers aponeurosis (fascia) or endopelvic fascia and is fused to the underside of the posterior vaginal wall. […] The perineal body is located between the vaginal introitus and anus. It is the attachment for the perineal membrane, a portion of the levator ani, the external anal sphincter, and the rectovaginal (endopelvic) fascia. […] However, if this attachment is separated, as can occur during childbirth, the perineal body can become more mobile, leading to rectocele and perineal descent.

• #69 The relationship between obstructed defecation and true rectocele in patients with pelvic organ prolapse | Scientific Reports

  https://www.nature.com/articles/s41598-020-62376-2

  In POP patients, the prevalence rate of true rectocele and OD was 23% and 43%, respectively. […] True rectocele was significantly correlated with straining at stool, digitation, incomplete emptying and requirement of laxatives or enema. […] The prevalence rate of true rectocele was 23%. […] The odd ratio of true rectocele was 19.00 (95%CI, 8.21743.934). […] We found that the true rectocele was significantly correlated with OD. […] We also found that PVP was more severe in patients with rectocele, indicating the correlation between true rectocele and the severity of PVP. […] We found that the diagnosis of rectocele by TLUS was related to OD, indicating a certain value in anatomical evaluation of POP.

• #70 The relationship between obstructed defecation and true rectocele in patients with pelvic organ prolapse | Scientific Reports

  https://www.nature.com/articles/s41598-020-62376-2

  In POP patients, the prevalence rate of true rectocele and OD was 23% and 43%, respectively. […] True rectocele was significantly correlated with straining at stool, digitation, incomplete emptying and requirement of laxatives or enema. […] The prevalence rate of true rectocele was 23%. […] The odd ratio of true rectocele was 19.00 (95%CI, 8.21743.934). […] We found that the true rectocele was significantly correlated with OD. […] We also found that PVP was more severe in patients with rectocele, indicating the correlation between true rectocele and the severity of PVP. […] We found that the diagnosis of rectocele by TLUS was related to OD, indicating a certain value in anatomical evaluation of POP.

• #71 The relationship between obstructed defecation and true rectocele in patients with pelvic organ prolapse | Scientific Reports

  https://www.nature.com/articles/s41598-020-62376-2

  In POP patients, the prevalence rate of true rectocele and OD was 23% and 43%, respectively. […] True rectocele was significantly correlated with straining at stool, digitation, incomplete emptying and requirement of laxatives or enema. […] The prevalence rate of true rectocele was 23%. […] The odd ratio of true rectocele was 19.00 (95%CI, 8.21743.934). […] We found that the true rectocele was significantly correlated with OD. […] We also found that PVP was more severe in patients with rectocele, indicating the correlation between true rectocele and the severity of PVP. […] We found that the diagnosis of rectocele by TLUS was related to OD, indicating a certain value in anatomical evaluation of POP.

• #72 The relationship between obstructed defecation and true rectocele in patients with pelvic organ prolapse | Scientific Reports

  https://www.nature.com/articles/s41598-020-62376-2

  In POP patients, the prevalence rate of true rectocele and OD was 23% and 43%, respectively. […] True rectocele was significantly correlated with straining at stool, digitation, incomplete emptying and requirement of laxatives or enema. […] The prevalence rate of true rectocele was 23%. […] The odd ratio of true rectocele was 19.00 (95%CI, 8.21743.934). […] We found that the true rectocele was significantly correlated with OD. […] We also found that PVP was more severe in patients with rectocele, indicating the correlation between true rectocele and the severity of PVP. […] We found that the diagnosis of rectocele by TLUS was related to OD, indicating a certain value in anatomical evaluation of POP.

• #73 Rectal–vaginal pressure gradient in patients with pelvic organ prolapse and symptomatic rectocele | BMC Women’s Health | Full Text

  https://bmcwomenshealth.biomedcentral.com/articles/10.1186/s12905-021-01304-6

  The aim of this study is to examine the relationship between rectalvaginal pressure and symptomatic rectocele in patients with pelvic organ prolapse (POP). […] Weakening of the puborectalis and bulbocavernosus musculatures leads to an increased rectalvaginal pressure gradient and is considered the pathological basis of rectocele. […] The rectalvaginal pressure gradient was found to be a risk factor for symptomatic rectocele in patients with POP. A rectalvaginal pressure gradient of 27.5 cm H2O was suggested as the cut-off point of the elevated pressure gradient.

• #74 Rectocele: Causes, Symptoms, Diagnosis, Stages & Treatment

  https://my.clevelandclinic.org/health/diseases/17415-rectocele

  A rectocele is a condition where the tissue between your rectum and vagina weakens, causing your rectum to bulge onto your vagina’s back wall. […] Rectocele is one form of pelvic organ prolapse (POP), a condition where organs droop because of a weak pelvic floor. […] A rectocele occurs when your pelvic floor weakens. Several factors can contribute: […] A surgical procedure called posterior colporrhaphy is commonly used to repair rectoceles. […] A rectocele occurs because of injury or long-term weakening of your pelvic floor. It doesn’t heal on its own without treatment. […] Rectocele can worsen without treatment.

• #75 Rectocele: Causes, Symptoms, Diagnosis, Stages & Treatment

  https://my.clevelandclinic.org/health/diseases/17415-rectocele

  A rectocele is a condition where the tissue between your rectum and vagina weakens, causing your rectum to bulge onto your vagina’s back wall. […] Rectocele is one form of pelvic organ prolapse (POP), a condition where organs droop because of a weak pelvic floor. […] A rectocele occurs when your pelvic floor weakens. Several factors can contribute: […] A surgical procedure called posterior colporrhaphy is commonly used to repair rectoceles. […] A rectocele occurs because of injury or long-term weakening of your pelvic floor. It doesn’t heal on its own without treatment. […] Rectocele can worsen without treatment.

• #76 Rectocele: Causes, Symptoms, Diagnosis, Stages & Treatment

  https://my.clevelandclinic.org/health/diseases/17415-rectocele

  A rectocele is a condition where the tissue between your rectum and vagina weakens, causing your rectum to bulge onto your vagina’s back wall. […] Rectocele is one form of pelvic organ prolapse (POP), a condition where organs droop because of a weak pelvic floor. […] A rectocele occurs when your pelvic floor weakens. Several factors can contribute: […] A surgical procedure called posterior colporrhaphy is commonly used to repair rectoceles. […] A rectocele occurs because of injury or long-term weakening of your pelvic floor. It doesn’t heal on its own without treatment. […] Rectocele can worsen without treatment.

• #77 Posterior Vaginal Prolapse (Rectocele) – Giggles – Giggles

  http://giggles.co.in/departments/posterior-vaginal-prolapse-rectocele/

  Rectocele is a condition where the tissue wall between the rectum and vaginal wall weakens and collapses. This causes the front wall of the rectum to sag and bulge into the vagina, and in severe cases, protrude outside the vaginal opening due to insufficient support from pelvic floor muscles and ligaments. […] Prolonged pressure on the pelvic floor results in rectocele. Rectocele risk factors could include pregnancy and childbirth, particularly multiple vaginal births or labors that end in tearing or episiotomies, aging, persistent constipation, obesity, previous surgery, heavy lifting, and chronic bronchitis or cough. […] Rectocele can get worse if left untreated. Not all rectocele cases need surgery. Despite this, you might need to consume more fiber, conduct daily Kegels, utilize a pessary, etc., depending on how severe your rectocele is.

• #78 The Pathophysiology, Diagnosis, and Management of Rectoceles | GLOWM

  https://www.glowm.com/section-view/heading/The-Pathophysiology-Diagnosis-and-Management-of-Rectoceles/item/58

  A rectocele is an outpocketing of the anterior rectal and posterior vaginal wall into the lumen of the vagina. Some rectoceles may be asymptomatic, whereas others may cause symptoms of incomplete bowel emptying, vaginal mass, pain, and pressure. The incidence of rectoceles is 20-80% in the general population and is thought to be increasing. A rectocele is fundamentally a defect of the rectovaginal septum, not of the rectum. The size of the defect does not correlate with the amount of functional derangement. […] The most common causes of rectoceles are obstetric events. Traumatic obstetric events, which usually occur when the presenting part descends quickly in the second stage of labor, can predispose to rectocele formation. The forces of labor may separate, tear, or distend the pelvic floor, altering the functional and anatomic position of the muscles, nerves, and connective tissues. The rectal fascia may separate from the perineal body, causing a transverse defect and low rectocele. Low rectoceles are an isolated defect in the suprasphincteric portion of the rectovaginal fascia.

• #79 The Pathophysiology, Diagnosis, and Management of Rectoceles | GLOWM

  https://www.glowm.com/section-view/heading/The-Pathophysiology-Diagnosis-and-Management-of-Rectoceles/item/58

  A rectocele is an outpocketing of the anterior rectal and posterior vaginal wall into the lumen of the vagina. Some rectoceles may be asymptomatic, whereas others may cause symptoms of incomplete bowel emptying, vaginal mass, pain, and pressure. The incidence of rectoceles is 20-80% in the general population and is thought to be increasing. A rectocele is fundamentally a defect of the rectovaginal septum, not of the rectum. The size of the defect does not correlate with the amount of functional derangement. […] The most common causes of rectoceles are obstetric events. Traumatic obstetric events, which usually occur when the presenting part descends quickly in the second stage of labor, can predispose to rectocele formation. The forces of labor may separate, tear, or distend the pelvic floor, altering the functional and anatomic position of the muscles, nerves, and connective tissues. The rectal fascia may separate from the perineal body, causing a transverse defect and low rectocele. Low rectoceles are an isolated defect in the suprasphincteric portion of the rectovaginal fascia.

• #80 Rectocele – Wikipedia

  https://en.wikipedia.org/wiki/Rectocele

  In gynecology, a rectocele or posterior vaginal wall prolapse results when the rectum bulges (herniates) into the vagina. Two common causes of this defect are childbirth and hysterectomy. Rectocele also tends to occur with other forms of pelvic organ prolapse, such as enterocele, sigmoidocele and cystocele. […] Rectoceles result from the weakening of the pelvic floor also called pelvic organ prolapse. Weakened pelvic structures occur as a result of an episiotomy during previous births, even decades later. Other causes of pelvic floor prolapse can be advanced age, multiple vaginal deliveries, and birthing trauma. Birthing trauma includes vacuum delivery, forceps delivery, and perineal tear. In addition, a history of chronic constipation and excessive straining with bowel movements are thought to play a role in rectocele. Multiple gynecological or rectal surgeries can also lead to weakening of the pelvic floor. […] A hysterectomy or other pelvic surgery can be a cause, as can chronic constipation and straining to pass bowel movements. It is more common in older women than in younger ones because estrogen which helps to keep the pelvic tissues elastic decreases after menopause.

• #81 Rectocele – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK546689/

  Rectoceles are a type of pelvic organ prolapse where the rectal tissue herniates through a defect in the rectovaginal septum into the vaginal lumen. […] Rectocele is a variety of pelvic organ prolapse (POP) that involves the herniation of the rectum through the rectovaginal septum into the posterior vaginal lumen. […] The loss of integrity in the rectovaginal fascia would result in a herniation of the rectal tissue into the vaginal lumen, and vice versa, leading to a vaginal bulge along the posterior vaginal wall on examination that would become more pronounced with the Valsalva maneuver. […] A rectocele occurs when healthy rectovaginal septal tissue loses integrity, and the rectum herniates through into the vaginal lumen. Loss of integrity can happen in a variety of ways, including childbirth, age-related connective tissue changes, and increased stress on the tissue through straining or obesity.

• #82 Rectocele – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/sites/books/NBK546689/

  Rectoceles are a type of pelvic organ prolapse where the rectal tissue herniates through a defect in the rectovaginal septum into the vaginal lumen. […] Rectocele is a variety of pelvic organ prolapse (POP) that involves the herniation of the rectum through the rectovaginal septum into the posterior vaginal lumen. […] The loss of integrity in the rectovaginal fascia would result in a herniation of the rectal tissue into the vaginal lumen, and vice versa, leading to a vaginal bulge along the posterior vaginal wall on examination that would become more pronounced with the Valsalva maneuver. […] A rectocele occurs when healthy rectovaginal septal tissue loses integrity, and the rectum herniates through into the vaginal lumen. Loss of integrity can happen in a variety of ways, including childbirth, age-related connective tissue changes, and increased stress on the tissue through straining or obesity.

• #83 Rectocele – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK546689/

  The posterior vaginal wall is supported by uterosacral ligament complex superiorly, levator ani muscles in the middle, and by the endopelvic fascia in the lower segments. The rectovaginal septum is attached to the endopelvic fascia at the level of the perineal body and runs between the vagina and rectum. The loss of integrity in this septum would result in a herniation of the rectal tissue into the vaginal lumen resulting in a vaginal bulge on examination. […] Many factors play a role in the loss of integrity of the rectovaginal septum, including non-modifiable and modifiable factors. […] Age, BMI, parity, and vaginal delivery are the most well-documented risk factors.

• #84 Rectocele: Practice Essentials, History of the Procedure, Epidemiology

  https://emedicine.medscape.com/article/268546-overview

  Rectocele is a defect of the rectovaginal septum, not the rectum. The pelvic surgeon must know the anatomy of the pelvic floor and the other supports of the vagina in order to diagnose and treat this disorder. […] The thin membranous connective tissue in the rectovaginal septum (and surrounding the entire vaginal tube) is called the Denonvilliers aponeurosis (fascia) or endopelvic fascia and is fused to the underside of the posterior vaginal wall. […] The perineal body is located between the vaginal introitus and anus. It is the attachment for the perineal membrane, a portion of the levator ani, the external anal sphincter, and the rectovaginal (endopelvic) fascia. […] However, if this attachment is separated, as can occur during childbirth, the perineal body can become more mobile, leading to rectocele and perineal descent.

• #85 The Pathophysiology, Diagnosis, and Management of Rectoceles | GLOWM

  https://www.glowm.com/section-view/heading/The-Pathophysiology-Diagnosis-and-Management-of-Rectoceles/item/58

  A rectocele is an outpocketing of the anterior rectal and posterior vaginal wall into the lumen of the vagina. Some rectoceles may be asymptomatic, whereas others may cause symptoms of incomplete bowel emptying, vaginal mass, pain, and pressure. The incidence of rectoceles is 20-80% in the general population and is thought to be increasing. A rectocele is fundamentally a defect of the rectovaginal septum, not of the rectum. The size of the defect does not correlate with the amount of functional derangement. […] The most common causes of rectoceles are obstetric events. Traumatic obstetric events, which usually occur when the presenting part descends quickly in the second stage of labor, can predispose to rectocele formation. The forces of labor may separate, tear, or distend the pelvic floor, altering the functional and anatomic position of the muscles, nerves, and connective tissues. The rectal fascia may separate from the perineal body, causing a transverse defect and low rectocele. Low rectoceles are an isolated defect in the suprasphincteric portion of the rectovaginal fascia.

• #86 The Pathophysiology, Diagnosis, and Management of Rectoceles | GLOWM

  https://www.glowm.com/section-view/heading/The%20Pathophysiology,%20Diagnosis,%20and%20Management%20of%20Rectoceles/item/58

  A rectocele is fundamentally a defect of the rectovaginal septum, not of the rectum. […] The most common causes of rectoceles are obstetric events. Traumatic obstetric events, which usually occur when the presenting part descends quickly in the second stage of labor, can predispose to rectocele formation. […] Midvaginal rectoceles most likely are caused by obstetric trauma not involving the levator ani. The rectovaginal fascia is damaged by the stretching and laceration of the tissue, which results in thinning of the fascia, leading to subsequent adhesion formation. […] High rectoceles often occur from pathologic overstretching of the posterior vaginal wall. […] Rectoceles may result secondarily from pathologic stretching of the pudendal nerves during descent of the fetal head, causing atrophy and denervation of the pelvic floor muscles. […] Defecation disorders may cause a subgroup of rectoceles. […] Congenital absence of the perineum may mimic a rectocele. […] Some studies have observed differences in connective tissue strengths between races, which may contribute to rectoceles.

• #87 Posterior vaginal prolapse (rectocele) | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/posterior-vaginal-prolapse-rectocele?content_id=CON-20314570

  A posterior vaginal prolapse, also known as a rectocele, occurs when the wall of tissue that separates the rectum from the vagina weakens or tears. […] Childbirth-related tears, chronic straining to pass stool (constipation) and other activities that put pressure on pelvic tissues can lead to posterior vaginal prolapse. […] Posterior vaginal prolapse results from pressure on the pelvic floor or trauma. Causes of increased pelvic floor pressure include: Birth-related tears, Forceps or operative vaginal deliveries, Long-lasting constipation or straining with bowel movements, Long-lasting cough or bronchitis, Repeated heavy lifting, Being overweight. […] The muscles, ligaments and connective tissue that support the vagina stretch during pregnancy, labor and delivery. This can make those tissues weaker and less supportive. The more pregnancies you have, the greater your chance of developing posterior vaginal prolapse.

• #88 Women’s Wellness: Problems with a posterior vaginal prolapse – Mayo Clinic News Network

  https://newsnetwork.mayoclinic.org/discussion/womens-wellness-posterior-vaginal-prolapse-rectocele/

  A posterior vaginal wall prolapse occurs when the thin wall of tissue that separates the rectum from the vagina weakens, allowing the vaginal wall to bulge. Posterior vaginal prolapse is also called a „rectocele”(REK-toe-seel). […] Childbirth and other processes that put pressure on pelvic tissues can lead to posterior vaginal prolapse. […] Posterior vaginal prolapse results from pressure on the pelvic floor. Causes of increased pelvic floor pressure include: Chronic constipation or straining with bowel movements, Chronic cough or bronchitis, Repeated heavy lifting, Being overweight or obese. […] The muscles, ligaments and connective tissue that support your vagina become stretched and weakened during pregnancy, labor and delivery. The more pregnancies you have, the greater your chance of developing posterior vaginal prolapse.

• #89 Posterior vaginal prolapse (rectocele) | Altru Health System

  https://www.altru.org/health-library/conditions/posterior-vaginal-prolapse-rectocele

  Some people are born with weaker connective tissues in the pelvic area. This makes them naturally more likely to develop posterior vaginal prolapse. […] Having vaginally delivered more than one child increases the risk of developing posterior vaginal prolapse. […] Growing older causes loss of muscle mass, elasticity and nerve function, which causes muscles to stretch or weaken. […] Extra body weight places stress on pelvic floor tissues. […] Kegel exercises strengthen pelvic floor muscles. A strong pelvic floor provides better support for pelvic organs. It also might relieve bulge symptoms that posterior vaginal prolapse can cause.

• #90 Posterior vaginal prolapse (rectocele) | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/posterior-vaginal-prolapse-rectocele?content_id=CON-20314570

  Some people are born with weaker connective tissues in the pelvic area. This makes them naturally more likely to develop posterior vaginal prolapse. […] Having vaginally delivered more than one child increases the risk of developing posterior vaginal prolapse. […] Surgery to fix the prolapse might be needed if: Pelvic floor strengthening exercises or using a pessary doesn’t control your prolapse symptoms well enough. […] Surgery often involves removing extra, stretched tissue that forms the vaginal bulge. Then stitches are placed to support pelvic structures.

• #91 Women’s Wellness: Problems with a posterior vaginal prolapse – Mayo Clinic News Network

  https://newsnetwork.mayoclinic.org/discussion/womens-wellness-posterior-vaginal-prolapse-rectocele/

  Factors that may increase your risk of posterior vaginal prolapse include: Genetics Some women are born with weaker connective tissues in the pelvic area, making them naturally more likely to develop posterior vaginal prolapse. Childbirth If you have vaginally delivered multiple children, you have a higher risk of developing posterior vaginal prolapse.

• #92 Pathogenesis of vaginal prolapse with the formation of rectocele: a review – Radzinsky – Gynecology

  https://journal-vniispk.ru/2079-5831/article/view/89026

  To carry out a systematic analysis of the data available in the modern literature on the pathogenesis of the formation of vaginal prolapse with the formation of rectocele rectum. The failure of the pelvic floor, namely its posterior compartment with the formation of a rectocele against the background of the lowering of the posterior vaginal wall, continues to be one of the most common gynecological diseases. […] Analyzing the above-mentioned data, it can be noted that the research data of recent years have significantly expanded the understanding of the etiology and pathogenesis of pelvic organ prolapse in its posterior compartment. […] However, the issues of etiology and pathogenesis of genital prolapse in patients of reproductive age, the role of individual risk factors and their combinations, pathogenetic mechanisms of development are still far from being resolved. […] Unfortunately, none of the above theories fully explains all the reasons for the formation of pelvic organ prolapse in its posterior compartment.

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