Brief Answer:
Following answers to your questions...

Detailed Answer:
Hi there my dear,

First, congratulations for your baby!

Rectocele is bulging of the front wall of the rectum into the back wall of vagina. Most probably, this has happened due to weakening of pelvic floor muscles and because the tissue (septum) between rectum and vagina has got thinner during labour.

1- Can you assess whether my rectocele is severe by my description? My doctor did not say.
Can severity by assessed with a visual examination?

Unfortunately, cannot determine the severity of the rectocele from what you are describing. Even a physical examination alone cannot determine its severity.

There is a specific X-ray examination called "defecography" through which the size of rectocele and ability to completely empty is being evaluated. If you are breastfeeding, this examination cannot be carried out as it might require exposure to X-ray.

The assessment is also based on clinical complaints you might have apart bulging:
- pain
- difficulties when passing bowel movement
- or any other symptoms?

2. Can it fix itself on its own? Perhaps when I stop breastfeeding.

Usually, rectocele does not have any symptom at all. The treatment is based on the clinical symptoms and nothing to do with breastfeeding. The aim is to prevent further complications or aggravation of symptoms.

3. Is surgery the only way to fix it?

No, surgery is necessary only when after medical management, the symptoms will continue or will get worse. Otherwise, the treatment is based only on medical management.

4. Do you have to fix it?

Once again, the aim is to alleviate the symptoms or prevent further complications.

5. How successful is surgery at solving the problem?

The success depends on the severity and duration of symptoms.

6. How dangerous is the surgery?

Usually, no problem might result during surgery. As for any other intervention, possible risks include: bleeding, infection, pain during sex (dyspaneuria).

7. Are rectoceles life threatening?

No, they are not life threatening, but can alter your quality of life.


8. Are there non-surgical methods I can try first? What are they?
What should I do to help myself? What should I avoid?

Yes, the very first approach is through medical management as following:
- avoid constipation : eat more foods high in fiber content or take fiber supplement
- increase water intake and take stool softeners to soften your feces and make bowel movement easier.
- do Kegel's exercises: they will help strengthen pelvic floor muscles
- do not strain while having bowel movement: avoid holding breath when passing stool; instead exhale during this process
- apply pressure to the back of vagina when passing motion

9. What does this mean for my sex life?

You can continue to have a normal sex life, but with some pain. Try to avoid hard sex and use lubricants.

Hope it was of help! If anything unclear, do not hesitate to contact me!
Dr.Albana

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