My gynecologist says I have a rectocele and it is causing me discomfort and incontienence. He thinks I should get surgery, but I don’t want that. What other options are there?

Rectoceles are relatively common in older women especially those who have had multiple vaginal births.  It is a result of weakening in the tissue between the vagina and rectum causing the rectum to bulge into the vagina.  This can result in a sensation of pelvic pressure, heaviness, constipation, and pelvic or back pain.  The condition is exacerbated by increased abdominal pressure (lifting, laughing, coughing, or defecating).  Treatment for symptomatic rectoceles are often surgical but people can also be treated with pessaries. Pessaries are intravaginal devices designed to support the vaginal wall and prevent the rectum from bulging into the vagina.  Your doctor should prescribe a vaginal cream (often estrogen) with the pessary to prevent damage and injury to the vaginal wall.