Why does rectocele cause vaginal bulge?

A rectocele develops when the supportive layer between the rectum and the back wall of the vagina becomes stretched or weakened. When you stand, strain or have a bowel movement, pressure inside the pelvis can push the rectal wall towards the vagina. This may create a soft fullness that feels or looks like something is coming down.

Some people also notice difficulty emptying the bowel, needing to press on the vaginal wall to pass stool, pelvic pressure or discomfort during sex. The size of the bulge and the symptoms do not always match, so an examination helps clarify the cause.

Arrange an appointment with a gynaecologist or pelvic-floor clinician if a bulge persists, interferes with bowel movements or affects daily activities. Keep stools soft with fluids and fibre if these suit you, avoid straining, and ask about pelvic-floor physiotherapy.

Treatment depends on symptoms and examination findings. Options may include observation, pelvic-floor support, a vaginal pessary or surgery when the prolapse is troublesome and other approaches have not helped.

Seek urgent help if the bulge becomes very painful, cannot be gently returned, bleeds, turns dark, or prevents you from passing urine or stool. Fever, severe pelvic pain or sudden worsening also needs prompt medical review.

Ask: Is this a rectocele or another type of prolapse? How strong are my pelvic-floor muscles? Would physiotherapy or a pessary help? How can I prevent straining? When would surgery be considered?