A rectocele is a hernia in the wall that separates the rectum from the vagina.

A hernia is a bulge that forms when the support tissue within the wall is damaged or weakened. Other areas of support in the pelvis can also be damaged. For example, a hernia in the front wall of the vagina that separates it from the bladder is called a cystocele. The general name for these conditions is pelvic floor prolapse.

Many factors may cause damage to the pelvic floor. The most important is injury from giving birth. Aging, smoking, genetic factors, and chronic stress on the pelvic floor (from lifting and straining) may contribute to the development of prolapse.

Prolapse can be mild, causing no symptoms. It can also be quite uncomfortable when the condition becomes more pronounced.

Women with larger rectoceles will often feel pressure and a sense of "something falling down". They may have difficulty moving their bowels and sometimes need to brace the area near the rectum to evacuate their stools. Intercourse may be uncomfortable as the bulging tissue creates a partial blockage within the vagina.

Treatment is not required for prolapse that causes little or no symptoms. If prolapse is bothersome, several treatments are available:

• Milder forms of prolapse may improve by practicing Kegel's exercises.
• A supporting brace (called a pessary) can be worn in the vagina to support the bulging walls.
• The damaged walls can be repaired surgically.

Gynecologists are trained to evaluate and treat prolapse. Specialists called urogynecologists have added expertise in treating these conditions, especially when surgery is needed.