In the same way that the wall separating the vagina and bladder can weaken, so can the separation between the rectum and the vagina. This results in relaxation and bulging of the rectum against the posterior or bottom facing wall of the bladder. This may also lead to discomfort after standing for long periods of time, during periods of exertion or during intercourse. Rectoceles are often known to cause difficulty with evacuating the bowels and an especially symptomatic patient may find that she actually needs to push against the skin of the vagina or perineum in order to help guide the stool out and more efficiently empty the bowels. As with the bladder, minimally symptomatic patients may observe this issue or opt for a pessary device. However, those who are more symptomatic or have more dramatic prolapse often require surgical intervention. These surgeries are performed on an outpatient basis as well, with most patients not requiring a urinary catheter following surgery.
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