Rectocele
Updates to Article Attributes
Rectocele refers to a herniation or bulge of the rectal wall, with the most common type being an anterior rectocele where the bulge is into the posterior vaginal wall in a female patient. Rectoceles can also occur posteriorly or laterally. Rectocele is the term most commonly used by colorectal surgeons, and the same entity is referred to as a posterior vaginal prolapse by urogynaecologists.
Clinical presentation
Typical presenting symptoms include:
- difficult defaecation with excessive straining
- perineal and vaginal pressure and bulging
- intermittent faecal soiling
-
requirementnecssesity to digitate to allow evacuation of stools
Pathology
Anterior rectocele results from a defect in the integrity of the rectovaginal septum with subsequent herniation of the rectal wall into the vagina and inferiorly into the perineum.
Associations
- increasing age
- parturition
Radiographic features
Clinical examination may reveal a rectocele and other pelvic organ prolapses such as a cystocele, and these are usually graded using the POP-Q system. Imaging is used to confirm the diagnosis and to evaluate for co-existing pelvic organ prolapse. Both fluoroscopic and MRI proctography can depict rectoceles, and they can be graded using MRI. Extension beyond the expected position of the normal anterior rectal wall is measured, and the severity of the rectocele graded as:
- < 2 cm: small
- 2-4 cm: medium
- > 4 cm: large
See also
-<li>requirement to digitate to allow evacuation of stools</li>- +<li>necssesity to digitate to allow evacuation of stools</li>
-</ul><h4>Radiographic features</h4><p>Clinical examination may reveal a rectocele and other pelvic organ prolapses such as a cystocele, and these are usually graded using the POP-Q system. Imaging is used to confirm the diagnosis and to evaluate for co-existing pelvic organ prolapse. Both <a href="/articles/evacuation-proctography">fluoroscopic</a> and <a href="/articles/mr-defaecating-proctography">MRI proctography</a> can depict rectoceles.</p><h4>See also</h4><ul><li><a href="/articles/rectal-prolapse">rectal prolapse</a></li></ul>- +</ul><h4>Radiographic features</h4><p>Clinical examination may reveal a rectocele and other pelvic organ prolapses such as a cystocele, and these are usually graded using the POP-Q system. Imaging is used to confirm the diagnosis and to evaluate for co-existing pelvic organ prolapse. Both <a href="/articles/evacuation-proctography">fluoroscopic</a> and <a href="/articles/mr-defaecating-proctography">MRI proctography</a> can depict rectoceles, and they can be graded using MRI. Extension beyond the expected position of the normal anterior rectal wall is measured, and the severity of the rectocele graded as:</p><ul>
- +<li>< 2 cm: small</li>
- +<li>2-4 cm: medium</li>
- +<li>> 4 cm: large</li>
- +</ul><h4>See also</h4><ul><li><a href="/articles/rectal-prolapse">rectal prolapse</a></li></ul>
References changed:
- 6. Laura García del Salto, Jaime de Miguel Criado, Luis Felipe Aguilera del Hoyo, Leticia Gutiérrez Velasco, Patricia Fraga Rivas, Marcos Manzano Paradela, María Isabel Díez Pérez de las Vacas, Ana Gloria Marco Sanz, Eduardo Fraile Moreno. MR Imaging–based Assessment of the Female Pelvic Floor. (2014) RadioGraphics. 34 (5): 1417-39. <a href="https://doi.org/10.1148/rg.345140137">doi:10.1148/rg.345140137</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/25208288">Pubmed</a> <span class="ref_v4"></span>
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