Differences between a cystocele and a rectocele
Can you have both Cystocele and Rectocele?
What causes Rectocele and Cystocele?
Is a Rectocele a prolapse?
How long does it take to recover from Rectocele and Cystocele surgery?
Differences between a cystocele and a rectocele
A cystocele is a stretch related weakness in the ceiling of the vagina, which allows the bladder to push the ceiling of the vagina in. A rectocele is a stretch related weakness in the floor of the vagina, which allows the rectum to push the floor of the vagina in. These weaknesses are often caused by childbirth or sometimes frequent, very heavy lifting. Often these are small and of no discomfort, thus need no repair. The larger, more uncomfortable bulging weaknesses may benefit from surgical repair, which is very effective.
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Can you have both Cystocele and Rectocele?
Symptoms include pelvic or vaginal fullness or pressure. Treatment includes conservative management with observation, pessaries, pelvic muscle exercises, and sometimes surgery. Cystocele, urethrocele, enterocele, and rectocele are particularly likely to occur together. Urethrocele is virtually always accompanied by cystocele (cystourethrocele).
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What causes Rectocele and Cystocele?
Rectocele causes
A rectocele usually happens with pregnancy and childbirth, but the risk also increases with age, and other factors can play a role.
The underlying cause is a weakening of the pelvic support structures and of the rectovaginal septum, the layer of tissue that separates the vagina from the rectum.
- Pregnancy and childbirth
Pregnancy and delivery are major factors in the development of a rectocele.
It is more likely to occur as a result of childbirth if the baby was large (weighing over 9 pounds) if labor was prolonged, or if there was a multiple birth, for example, twins.
The more vaginal deliveries a woman has had, the more chance she has of developing a rectocele.
The risk is lower with a cesarean delivery, but a rectocele can still happen.
- Older age
By the age of 50 years around half of all women have some symptoms of a pelvic organ prolapse, and by the age of 80 years, over 1 in every 10 will have had surgery for prolapse.
If the rectocele is small, the person may not notice it. If it is large, they may notice tissue protruding through the vaginal opening. There may be some discomfort, pressure, and, in some cases, pain.
- Other factors
Those who have never given birth can also develop a rectocele.
The following are risk factors:
- a drop in estrogen levels at menopause, making pelvic tissues less elastic
- a hysterectomy or other pelvic surgery
- chronic constipation
- long-term coughing, such as in chronic bronchitis
- sexual abuse during childhood
- being obese or overweight
- regularly lifting heavy objects
There may be an indirect link with hemorrhoids. If a person with other risk factors also has chronic constipation, for example, a forced bowel movement may increase intra-abdominal pressure during straining. This could trigger a rectocele.
If a person undergoes several gynecological or rectal surgeries, this can also weaken the pelvic floor and lead to a rectocele.
In men, a rectocele can develop as the result of a prostatectomy, which is the removal of the prostate gland, as a treatment for prostate cancer.
Women are more likely than men to have a rectocele.
Cystocele causes
Factors that increase your risk of a cystocele are childbirth, age, obesity, chronic constipation and heavy lifting.
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Is a Rectocele a prolapse?
A rectocele is a type of pelvic organ prolapse. It happens when the supporting ligaments and muscles weaken in the pelvic floor. Other names for a rectocele are a posterior vaginal wall prolapse or proctocele. Childbirth and other processes that put pressure on pelvic tissues can lead to posterior vaginal prolapse. A small prolapse may cause no signs or symptoms.
If a posterior vaginal prolapse is large, it may create a noticeable bulge of tissue through the vaginal opening. This bulge may be uncomfortable, but it's rarely painful.
If needed, self-care measures and other nonsurgical options are often effective. Severe posterior vaginal prolapse might require surgical repair.
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How long does it take to recover from Rectocele and Cystocele surgery?
You can expect to feel better and stronger each day, although you may get tired quickly and need pain medicine for a week or two. You may need about 4 to 6 weeks to fully recover from open surgery and 1 to 2 weeks to recover from laparoscopic surgery or vaginal surgery.
It is important to avoid heavy lifting while you are recovering, so that your incision can heal. This care sheet gives you a general idea about how long it will take for you to recover. But each person recovers at a different pace. Follow the steps below to get better as quickly as possible.
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