This condition results from weakening of the supporting structures in the pelvic floor muscles. The rectum gradually pouches out anteriorly into the posterior vagina when one is straining to have a bowel movement. This pouch in some instances tends to trap stool, which can lead to obstruction and difficult evacuation. With difficult evacuation, the patient strains more and the trapping and obstruction worsens, hence resulting in a vicious cycle. When no other confounding pathology is identified, a direct repair of the rectocele is carried out to provide symptom relief.