A rectocele occurs when the end of the large intestine (rectum) pushes against and moves the back wall of the vagina. An enterocele (small bowel prolapse) occurs when the small bowel presses against and moves the upper wall of the vagina. Rectoceles and enteroceles develop if the lower pelvic muscles become damaged by labor, childbirth, or a previous pelvic surgery or when the muscles are weakened by aging. A rectocele or an enterocele can be present at birth (congenital), though this is rare.
A rectocele or an enterocele may become large or more obvious when you strain or bear down (for example, during a bowel movement). Rectocele and enterocele formation may occur together, especially if you have had surgery to remove the uterus (hysterectomy).
Because rectocele and enterocele are defects of the pelvic supporting tissue and not the bowel wall, they are treated most successfully with surgery that repairs the vaginal wall. This surgery pulls together the stretched or torn tissue in the area of prolapse. Surgery will also strengthen the wall of the vagina to prevent prolapse from recurring. Unless there is another health problem that would require an abdominal incision, rectoceles and enteroceles are usually repaired through the vagina.
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