In women, the vagina is separated from the rectum by a firm wall of tough, fibrous tissue called fascia. Sometimes, an area of this wall gets weak, and part of the rectum bulges into the vagina. This bulge is called a rectocele.
The problem usually develops after the wall is damaged during a vaginal delivery. The bulge may occur after a vaginal delivery, but symptoms may not develop until later in life. Rectoceles are more commonly seen in older women who have entered menopause.
Some conditions can increase the risk of developing rectocele, including chronic constipation, chronic cough, repetitive heavy lifting, or any activity that puts pressure on the pelvic floor over time.
Because small rectoceles often do not cause any symptoms, it is difficult for health experts to determine exactly how often they occur. As few as 20%, or as many as 80% of adult women may be affected, but rectoceles are most commonly seen in older women who have had multiple vaginal deliveries. In 1 recent study of 125 women in the United States who had rectoceles, the typical patient was about 60 years old, going through menopause, and had gone through 2 or 3 vaginal deliveries. A woman with a rectocele is also likely to have related conditions, including a cystocele (an abnormal bulging of the bladder through a weakness in the anterior vaginal wall) and uterine prolapse (abnormal sagging of the uterus into the vagina because of loss of its pelvic support).