Urogynecologic Condition
A rectocele is a form of pelvic organ prolapse in which the rectum bulges forward into the back wall of the vagina. Many patients first notice it as difficulty completing a bowel movement — or a sense that stool is "stuck" and needs to be pressed on the vaginal wall to pass.
It is a common condition, particularly after vaginal childbirth, and one that is typically responsive to conservative care. Surgery is available when symptoms are significant — but it is rarely the first step.
Most patients tell us they assumed the symptom was minor — or just something they would have to live with. Neither is usually true.
Treatment Approach
Most patients with rectocele improve significantly with behavioral, physical, and minimally invasive treatments — long before surgery enters the conversation. Here is the full toolbox, in the order we typically work through it.
Surgery is one tool in a much larger toolbox. When we do recommend a procedure, it is because we have a specific reason — and we will explain exactly what it does, what it doesn't do, and what recovery actually looks like.
What to Expect
A comprehensive first evaluation with Dr. Johnson. Time to be listened to. In-office diagnostics when possible.
Dr. Johnson has read your intake before you walk in. The conversation starts with the impact on your life — not the textbook.
Performed with explanation at every step. Nothing happens without your full awareness and consent.
Diagnostics are performed in-office where possible to avoid extra appointments.
Every option explained. Pros, cons, and what each one would mean for your week, your work, and your life.
A Patient Story
I had been splinting for two years and never told a soul. Dr. Johnson didn't flinch. She walked me through the pessary option, then through the surgery option. I picked the surgery, and I have not splinted since.
— D.K., treated for symptomatic rectocele
Frequently Asked
It is not dangerous, but it is a strong signal that the rectocele is significant enough to be worth evaluating. Most patients who splint daily are reasonable candidates for either conservative or surgical treatment, depending on their goals.
— Lisa L. Johnson, M.D., U.R.P.S.
No. Many rectoceles cause minor symptoms that resolve with bowel regimen changes and PT. We only recommend surgical repair when symptoms are significantly affecting daily life and when conservative measures have not delivered enough.
— Lisa L. Johnson, M.D., U.R.P.S.
Most patients are back to office work in one to two weeks, with a six-week restriction on heavy lifting and strenuous activity. The six-week rule matters: pushing through it is one of the most common causes of recurrence.
— Lisa L. Johnson, M.D., U.R.P.S.
For nearly all patients with a primary symptomatic rectocele, no. The repair restores the supportive layer that allows stool to pass through the rectum normally. We discuss expected outcomes — and possible exceptions — before any procedure.
— Lisa L. Johnson, M.D., U.R.P.S.
No, though they sometimes coexist. A rectocele is a structural issue with the vaginal-rectal support layer. A hemorrhoid is a swollen vascular cushion in or around the anus. Both can cause discomfort with bowel movements — and at PHII, we treat both, often in the same patient.
— Lisa L. Johnson, M.D., U.R.P.S.
A thorough, unhurried evaluation with Dr. Johnson. You will leave with a written plan — and clarity on what rectocele is doing in your body, and what to do about it.
