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Cystocele & Rectocele: What do these words mean?

Question: “Cystocele and Rectocele – what do these words mean?”

Answer from Dr. Daniel Gruber, urogynecologist from Sibley Memorial Hospital in Washington D.C., part of John Hopkins medicine. 

A cystocele is where the front wall of the vagina bulges down and sometimes it can bulge down and out. Right behind it is the bladder, so the bladder can drop down, in which case the person can feel pressure sensation and bulging. We often describe how much is coming out of the body in terms of fruit. Is it a grape size? Is it a plum? Orange? 

A cystocele can be from very small if it is inside the vagina a little bit. In these cases, most women won’t even notice it’s there. 

Truthfully, they don’t really matter that much in most cases. When it starts to come out, that’s when most people will notice it. And we have lots of different ways of treating cystoceles as well, including pessaries, surgery, and sometimes exercises as well. 

A rectocele is a bulge that occurs in the back wall or posterior wall of the vagina, with the rectum right behind it. So as this bulges, the rectum comes down again. It’s mostly bothersome when it starts to work its way out of the body. However, it can make defecation very difficult, because stool can get trapped in the pocket that’s created. 

A lot of times women will have to use their finger to push down in the vagina but on the rectum to help stool come out. We call this ‘splinting,’ and it is perfectly fine to do. A lot of people figure out how to do this on their own, and there’s no harm in it whatsoever. It’s actually a good thing because it’s better than straining constantly.

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