Rectocele Care in Grand Rapids, Michigan

A rectocele is a type of pelvic organ prolapse that occurs when the rectum pushes against and bulges into the back wall of the vagina. This can create a noticeable bulge inside the vagina and, in more severe cases, may even protrude outside the vaginal opening.

In Grand Rapids, women with rectocele can find expert evaluation and treatment through major health systems such as Corewell Health (formerly Spectrum Health), Trinity Health Grand Rapids, University of Michigan Health–West (Metro Health), and Mercy Health. Early diagnosis and treatment can significantly improve comfort, bowel function, and quality of life.

What Is a Rectocele?

A rectocele happens when the rectovaginal septum—the thin wall of tissue between the rectum and vagina—becomes weakened or stretched. This allows the front wall of the rectum to bulge into the vagina.

How Severe Can a Rectocele Be?

Severity can vary:

  • Mild rectocele
    • Small bulge felt high inside the vagina
    • Often noticed only during a pelvic exam
  • Moderate rectocele
    • Bulge felt lower in the vagina
    • May cause trouble with bowel movements
  • Severe rectocele
    • Bulge may reach or protrude outside the vaginal opening
    • Can cause significant discomfort and difficulty with bowel movements and intercourse

Even women who have never had children can develop a rectocele, although vaginal childbirth is a major risk factor.

Pelvic Floor Support and Rectocele

Your pelvic organs (uterus, bladder, rectum) are supported by:

  • Pelvic floor muscles
  • Ligaments
  • Connective tissue, including the rectovaginal septum

Over time, or after certain events, these supports can weaken.

Causes and Risk Factors

Common causes and risk factors for rectocele include:

  • Vaginal childbirth
    • Long or difficult labor
    • Use of forceps or vacuum during delivery
    • Tearing during childbirth, especially tears extending from the vagina to the anus
    • Episiotomy (a cut made to enlarge the vaginal opening), particularly if it extends toward the anus
  • Multiple vaginal births
  • Pelvic surgery
    • Hysterectomy (removal of the uterus)
    • Other gynecologic or colorectal surgeries
  • Chronic constipation and straining
    • Common in cold Michigan winters when people may be less active and drink less water
  • Ageing
    • Tissue strength decreases with age; rectocele is more common in older women
  • Low estrogen levels after menopause
  • Heavy lifting or chronic coughing
    • Smoking-related cough or chronic lung disease

A rectocele may occur alone or alongside other pelvic organ prolapse conditions, such as:

  • Cystocele – bladder bulging into the vagina
  • Enterocele – small intestine pushing into the vagina
  • Uterine prolapse – uterus and cervix dropping into or out of the vagina
  • Rectal prolapse – rectum protruding through the anus

Symptoms of Rectocele

Symptoms can be vaginal, rectal, or both. Not every woman will have all of these symptoms.

Vaginal Symptoms

  • Sensation of pressure or fullness in the pelvis or vagina
  • Feeling that something is “falling down” or “falling out”
  • Bulging mass felt inside the vagina
  • Bulge visible at or outside the vaginal opening in more severe cases
  • Vaginal bleeding not related to your menstrual cycle
  • Painful or difficult vaginal intercourse

Symptoms often:

  • Worsen with standing, lifting, or at the end of the day
  • Improve when lying down

Bowel and Rectal Symptoms

  • Constipation
  • Needing to strain to have a bowel movement
  • Feeling that the bowel is not completely empty after a movement
  • Stool becoming trapped in the bulge of the rectocele
  • Needing to press a finger against the back wall of the vagina to help stool pass (called “splinting”)
  • Occasional fecal incontinence (leakage of stool or gas)

If you notice these symptoms in Grand Rapids or the surrounding Kent County area, consider scheduling an evaluation with a gynecologist, urogynecologist, or colorectal surgeon at a local health system.

Diagnosis of Rectocele in Grand Rapids

Rectocele is usually diagnosed with:

1. Medical History

Your provider will ask about:

  • Childbirth history
  • Prior pelvic or rectal surgeries
  • Bowel habits and constipation
  • Urinary and sexual function
  • How symptoms affect daily activities and work

2. Pelvic Examination

A pelvic exam is the primary way to diagnose rectocele. During the exam, you may be asked to:

  • Bear down (as if having a bowel movement)
  • Cough or strain

This helps your provider see or feel any bulging of the vaginal wall.

3. Imaging or Specialized Tests (If Needed)

In some cases, especially when symptoms are complex, your provider may order:

  • Defecography (proctogram or defecogram) – a special X-ray or MRI study to see how the rectum and pelvic floor work during a bowel movement
  • Endoanal or pelvic ultrasound
  • Colonoscopy (if there are concerns about other bowel conditions)

These tests are available through major Grand Rapids health systems such as Corewell Health, Trinity Health Grand Rapids, and U-M Health–West.

Non-Surgical Treatment Options

Many women in Grand Rapids can manage mild to moderate rectocele without surgery. Treatment focuses on strengthening the pelvic floor and reducing strain on the rectum.

Lifestyle and Bowel Management

Because Michigan’s cold winters and seasonal changes can affect activity levels and hydration, constipation is common. To reduce rectocele symptoms:

  • High-fiber diet
    • Eat plenty of fruits, vegetables, whole grains, beans, and lentils
  • Fibre supplements
    • Psyllium or other fiber supplements if dietary fiber is not enough
  • Hydration
    • Aim for 6–8 glasses of water per day, more if recommended by your provider
  • Stool softeners
    • Use stool softeners if recommended; avoid long-term use of stimulant laxatives unless directed by a doctor
  • Avoid straining on the toilet
    • Take your time, and use proper posture (feet supported, leaning slightly forward)

The Kent County Health Department and Grand Rapids Public Health resources often provide general guidance on healthy eating and bowel health that can support these efforts.

Pelvic Floor (Kegel) Exercises

Pelvic floor exercises help strengthen the muscles that support the vagina and rectum.

  • Tighten the muscles you would use to stop urine flow
  • Hold for a few seconds, then relax
  • Repeat several times, multiple times per day

A pelvic floor physical therapist in Grand Rapids can:

  • Teach correct Kegel technique
  • Provide biofeedback or other therapies to improve pelvic support

Ask your provider for a referral to pelvic floor physical therapy through local systems like Corewell Health, Trinity Health, or U-M Health–West.

Vaginal Pessary

A pessary is a small, usually silicone device placed in the vagina to support pelvic organs.

  • Fitted by a gynecologist or urogynecologist
  • Can help reduce bulging and pelvic pressure
  • Often used in women who:
    • Prefer to avoid surgery
    • Are not good surgical candidates
    • Are awaiting surgery

Pessary care includes regular follow-up visits in clinic to clean, check, and refit the device as needed.

Hormone Therapy (Postmenopausal Women)

For some postmenopausal women:

  • Topical vaginal estrogen may be recommended to improve tissue strength and decrease irritation
  • Systemic hormone replacement therapy may be considered in specific cases, based on overall health and risk factors

Discuss risks and benefits with your Grand Rapids gynecologist or primary care provider.

Surgery may be recommended if:

  • Symptoms are significant and interfere with daily life, work, or intimacy
  • Non-surgical treatments have not improved symptoms
  • There are multiple pelvic organ prolapses (e.g., rectocele plus uterine prolapse or cystocele)

In Grand Rapids, rectocele surgery is commonly performed by:

  • Urogynecologists
  • Gynecologic surgeons
  • Colorectal surgeons
  • General surgeons with pelvic floor expertise

You can find these specialists at Corewell Health, Trinity Health Grand Rapids, U-M Health–West, and Mercy Health.

Types of Rectocele Surgery

The goal of surgery is to repair and strengthen the wall between the vagina and rectum and restore normal anatomy.

Surgical approaches include:

1. Vaginal Approach (Most Common)

  • One or more incisions are made along the back wall of the vagina
  • The rectovaginal septum and surrounding tissues are brought together and reinforced with absorbable stitches
  • Pelvic floor muscles around the vagina and rectum may be tightened
  • If the vagina has been stretched (for example, after childbirth), excess tissue may be removed
  • The vaginal incisions are closed with absorbable stitches
  • Sometimes the perineum (area between the vagina and anus) is also repaired with deep stitches into the muscle

2. Perineal, Anal, or Abdominal Approaches

In selected cases, the surgeon may approach the rectocele:

  • Through the anus
  • Through the perineum (between the vagina and anus)
  • Through the abdomen, especially if combined with other prolapse repairs

Your surgeon will explain which approach is best based on:

  • Severity of the rectocele
  • Presence of other prolapses (uterine, bladder, rectal)
  • Your overall health and surgical history

Sometimes a combination of techniques is needed.

Immediately After Rectocele Surgery

After surgery in a Grand Rapids hospital, you can generally expect:

  • Hospital stay of about 3–6 days, depending on your health and the type of surgery
  • Monitoring of:
    • Temperature
    • Pulse
    • Breathing
    • Blood pressure
  • An intravenous (IV) line to provide fluids and medications
  • Pain-relieving medications
    • Tell your nurse if your pain is not well controlled
  • A urinary catheter to drain urine from your bladder for about a day or until you can urinate on your own
  • Vaginal packing (gauze in the vagina) to support the repair and reduce bleeding
    • Usually removed later the same day or the day after surgery

You will receive instructions for:

  • Activity limits
  • Bowel management
  • Follow-up appointments

Recovery at Home in Grand Rapids

What to Expect

  • Bloody vaginal discharge for about four weeks is common
  • Mild discomfort or pressure in the pelvic area
  • Gradual improvement in rectocele symptoms over several weeks

Activity and Self-Care

To protect your surgical repair:

  • Rest as much as you can, especially in the first few weeks
  • Avoid heavy lifting or straining (no lifting more than a light grocery bag)
  • Do not strain on the toilet
  • Follow your provider’s guidance on when to resume driving, work, exercise, and sexual activity
  • Plan for about six weeks off work, depending on your job and recovery

Preventing Constipation After Surgery

Constipation is a major concern after rectocele surgery, especially during Michigan winters when people may be less active. To reduce strain:

  • Eat a high-fiber diet
  • Use fibre supplements if needed
  • Drink plenty of water (unless your provider gives different instructions)
  • Use stool softeners as directed
  • Avoid long-term or frequent use of stimulant laxatives unless prescribed

Possible Complications of Rectocele Surgery

As with any surgery, there are risks. Possible complications include:

  • Allergic reaction to anesthesia
  • Bleeding (hemorrhage)
  • Infection at the incision or deeper tissues
  • Injury to nearby nerves or blood vessels
  • Damage to other pelvic organs, such as the bladder or rectum
  • Death (necrosis) of the rectal wall (rare but serious)
  • Recurrence of rectocele or other prolapse over time

Your surgeon will discuss these risks with you before surgery and explain how they are minimized.

When to Call Your Doctor

Contact your surgeon or seek urgent care at a Grand Rapids emergency department (such as at Corewell Health Butterworth Hospital, Trinity Health Grand Rapids, or U-M Health–West Hospital) if you experience:

  • Heavy vaginal bleeding
  • Fever or chills
  • Increasing pelvic or abdominal pain
  • Difficulty urinating or inability to urinate
  • Foul-smelling vaginal discharge
  • Redness, swelling, or drainage from incision sites

Local Resources for Rectocele Care in Grand Rapids

If you think you may have a rectocele, consider:

  • Your primary care provider – for initial evaluation and referral
  • Gynecologist or urogynecologist – for specialized pelvic exam and treatment options
  • Colorectal or general surgeon – if bowel symptoms are significant or surgery is considered

In Grand Rapids, you can seek care through:

  • Corewell Health (Spectrum Health) – gynecology, urogynecology, colorectal surgery, pelvic floor physical therapy
  • Trinity Health Grand Rapids – women’s health and pelvic floor services
  • University of Michigan Health–West (Metro Health) – colorectal and pelvic floor specialists
  • Mercy Health – gynecology and pelvic floor care
  • Kent County Health Department & Grand Rapids Public Health resources – general women’s health and wellness information

Key Points About Rectocele in Grand Rapids, MI

  • Rectocele occurs when the rectum bulges into the vagina due to weakening of the rectovaginal septum.
  • Symptoms may be vaginal, rectal, or both, and can include pelvic pressure, bulging, constipation, and sometimes fecal incontinence.
  • Lifestyle measures, including a high-fiber diet, good hydration, and avoiding straining, are essential—especially in Michigan’s colder months when constipation is more common.
  • Pelvic floor exercises, pessaries, and hormonal support can help manage mild to moderate rectocele.
  • Surgery may be needed if simpler treatments do not relieve symptoms or if the rectocele is severe.
  • Grand Rapids offers comprehensive rectocele care through multiple hospital systems, specialists, and pelvic floor therapists.

If you live in Grand Rapids or West Michigan and have symptoms of rectocele, schedule an appointment with a local women’s health or pelvic floor specialist to discuss diagnosis and personalized treatment options.