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A rectocele is the herniation of the rectum through the posterior vaginal wall. Most small rectoceles are asymptomatic, but symptoms of introital bulging, constipation, and incomplete rectal evacuation may occur. Physical examination may reveal bulging of the posterior vaginal wall through the introitus. A thin-walled protrusion of the rectovaginal septum into the lower part of the vagina is seen on internal vaginal examination.
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Management and Disposition
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ED management is symptomatic with hydration, laxatives, and stool softeners. Refer patients with large or symptomatic rectoceles to a gynecologist for possible surgical repair.
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Patients may complain of the need for manual reduction of the rectocele when defecating.
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