Dr. Daniel Stone, MD FACOG
Urogynecologist located in Phoenix, AZ
Dr. Daniel Stone, MD is one of the leading experts in the surgical and non-surgical management of rectoceles and other forms of Pelvic Organ Prolapse. Dr. Stone can diagnosis and provides management options for rectoceles to patients in the Phoenix, Scottsdale and surrounding Arizona areas.
Rectocele Q & A
What is a Rectocele?
A rectocele refers to the bulging of the front wall of the rectum into the back wall of the vagina and vaginal canal. It is also called posterior vaginal wall prolapse. It is not the same thing as rectal prolapse, which is a protrusion of the rectum out of the anal canal. It is a subcategory of pelvic organ prolapse.
What are the symptoms of Rectocele?Rectoceles often causes symptoms of vaginal bulge, pressure, and sensation of something falling out of the vagina. When a rectocele is more advanced the vaginal tissue can be felt or seen as it protrudes from the vaginal opening. These symptoms are commonly found in other forms of pelvic organ prolapse.Rectocele can also cause defecatory dysfunction. As a rectocele becomes more severe it can create a pocket where stool can collect and make it very difficult to empty. Often women will need to push with an object or finger in or around the vagina to assist in defecation.
What is the cause of a Rectocele?
Ultimately a rectocele forms due to the loss of pelvic floor support. Like other forms of pelvic organ prolapse, rectoceles can have many different causes and risk factors including:
- Pregnancy, labor, or childbirth especially vaginal births or large babies.
- Aging and/or menopause
- Chronic cough
- Constipation and straining
- Repetitive heavy lifting
How is a Rectocele diagnosed?
Dr. Stone will first discuss your symptoms with you. He will then perform a physical exam including a gynecologic exam. This exam is slightly different than a normal gynecologic exam as he will take measurements as you push to see how far the rectocele comes down. Base on these measurements, he will then be able to give you a stage of the rectocele and show you diagrams of what your anatomy is doing.
Are other disorders commonly found with a Rectocele?
As mentioned earlier, a rectocele is a subcategory of pelvic organ prolapse. Other forms of pelvic organ prolapse are commonly found when someone has a rectocele, including a Cystocele, Uterine prolapse, and Vaginal Vault Prolapse.
What are the conservative treatments for a Rectocele?
A "watch and wait" strategy could be used. This is best used if your rectocele is not causing any bothersome symptoms.
You can also change your lifestyle and behaviors to minimize or lessen your symptoms. Some of these changes can also slow down the progression. These include:
Avoid chronic straining by avoiding constipation and repetitive heavy lifting
Keep your weight in a normal range and lose weight if you are overweight.
You can also perform pelvic floor muscle exercises (Kegels) to help improve mild prolapse symptoms. Dr. Stone can also refer you to a specialized physical therapist that specializes in this area.
If you are having defecatory dysfunction, then keeping your bowel movements soft and regular can help.
A small silicone device called a pessary could also be used to manage a rectocele. A pessary can be inserted into the vagina to support the pelvic organs. Dr. Stone's office carries a variety of different shapes and sizes of pessaries and a fitting can be scheduled at your convenience.
What are the surgical treatments for a Rectocele?
The primary surgical repair is a rectocele repair. Dr. Stone performs a rectocele repair vaginally under general anesthesia. He makes an incision along the vaginal wall and the vaginal skin is carefully dissected from the underlying supportive tissue. He then uses an absorbable suture to strengthen the tissue. The excess vaginal tissue is then trimmed and the skin is closed with suture.
It is also important that any loss of apical support is addressed with a rectocele repair. As mentioned previously, rectocele often occurs in the setting of vaginal vault prolapse or uterine prolapse. If these forms of prolapse are also present, then a sacrocolpopexy, hysteropexy or vaginal vault suspension should be performed at the same time.
Major Insurance Providers Accepted
We accept most insurance policies for your convenience. Please contact your insurance carrier to verify your individual benefits and any copays or coinsurance that are part of your plan. Patients are responsible for notifying our office if a specific plan requires precertification, preauthorization, or a referral (especially HMOs). Please call the phone number on the back of your insurance card to verify your provider network participation as insurance carriers change policies often.
Phoenix, Arizona 85016-1302
Office Hours: Monday-Friday from 8 AM – 5 PM
Main: (602) 788-1521
Fax: (602) 688-5420
Conveniently located just off Highway 51 on Maryland Avenue just East of 16TH Street between East Bethany Home Road and East Glendale Avenue.