Pelvic Floor Ultrasound: The Rectocele

The symptomatic patient typically shows up with one or more of the following (from the most common to the rarest):

  • Vaginal bulge or foreign-body sensation
  • Chronic constipation
  • Vaginal digitation (digital assistance through the vagina for defecation)
  • Straining at stool
  • Sensation of incomplete bowel emptying
  • Faecal incontinence

Depicting a rectocele in pelvic floor ultrasound is feasible:

Rectocele in pelvic floor ultrasound. Structures from right to left: symphysis pubis, urethra and bladder, vagina and rectum.
A rectocele making itself obvious during valsalva. Blue: bladder and urethra. Green: Vagina. Red: Rectum.

Bibliography

  • Dietz, H. P., Zhang, X., Shek, K. L., & Guzman, R. R. (2015). How large does a rectocele have to be to cause symptoms? A 3D/4D ultrasound study. International urogynecology journal26(9), 1355–1359. https://doi.org/10.1007/s00192-015-2709-6

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