Pelvic organ prolapse (POP) is a common condition that is increasing in incidence. Many cases of prolapse of the posterior vaginal wall occur along with other pelvic support defects. Pelvic surgeons who treat rectocele must have an excellent understanding of the normal anatomy, interactions of the connective tissue and muscular supports of the pelvis, and the relationship between anatomy and function. These pelvic support defects may or may not cause symptoms. Pelvic pressure, vaginal protrusion, the need to splint the perineum to defecate, impaired sexual relations, difficult defecation, and fecal incontinence are some of the symptoms that have been described in patients with rectoceles. Whether prolapse is the cause or result of these symptoms is uncertain.
This article focuses on (1) current knowledge regarding the relationship of rectocele anatomy and function and (2) useful evaluations and treatments for women with rectoceles and defecation disorders.