A rectocele is a medical disorder that results from a tear in the rectovaginal septum (which is normally a tough, fibrous, sheet-like separator between the rectum and vagina).Rectal tissue bulges through this tear and into the vagina as a hernia.A rectocele is a herniation (bulge) of the front wall of the rectum into the back wall of the vagina.The wall between the rectum and the vagina is termed the rectovaginal septum.This structure can become weaken and thin over time, leading to a rectocele.When rectoceles are small, most women have no symptoms.A rectocele may be a weakened swelling or happen as part of a complete weakening of the pelvic floor muscles.Other pelvic tissue parts such as the bladder (cystocele) and the small intestine (enterocele), can protrude into the vagina, resulting in similar symptoms as rectocele.In women, the vagina is separated from the rectum by a firm wall of tough, fibrous tissue called fascia.Occasionally, a part of this wall becomes weak, and part of the rectum bulges into the vagina forming a rectocele.The protrusion may occur after a vaginal delivery but symptoms may not develop until later in life.Rectoceles are more frequently observed in older women who developed menopause.Some disorders can raise the danger of forming rectocele such as:1. Chronic constipation,2. Chronic cough,3. Repetitive heavy lifting4. Any activity that puts pressure on the pelvic floor over time.Rectoceles are most frequently observed in older women who have frequent vaginal childbirths.A woman with a rectocele also tends to have linked disorders such as:1. Cystocele (an abnormal bulging of the bladder through a weakness in the anterior vaginal wall)2. Uterine prolapse (abnormal sagging of the uterus into the vagina because of loss of its pelvic support).Symptomatic rectoceles normally happen together with weakening of the pelvic floor.There are many things which can lead to weakening of the pelvic floor such as:1. Advanced age,2. Multiple vaginal deliveries3. Birthing injury during vaginal childbirth (e.g. vacuum delivery, forceps delivery, tearing with a vaginal delivery, and episiotomy during vaginal delivery).As well, a history of prolonged constipation and excessive straining with bowel movements are believed to play a contributory factor in forming a rectocele.Multiple gynecological or rectal surgeries can also result in weakened muscles of the pelvic floor and rectocele formation.There are two main causes of this tear: childbirth, and hysterectomy.Diagnosis:Examination of the pelvic region involves both a vaginal and rectal examination.A special x-ray video, called defecography, can also observe and confirm a rectocele.Treatment:1.Changes in diet (higher intake in fiber and water),2.Pelvic floor exercises such as Kegel exercises,3.Use of stool softeners,4.Hormone replacement therapy for post-menopausal women5.Insertion of a pessary into the vagina,6.Various forms of surgery (posterior colporrhaphy or the suturing of vaginal tissue to the back of the pelvis).TABLE OF CONTENTIntroductionChapter 1 RectoceleChapter 2 CausesChapter 3 SymptomsChapter 4 DiagnosisChapter 5 TreatmentChapter 6 PrognosisChapter 7 Rectal ProlapseChapter 8 Uterine ProlapseEpilogue