A rectocele is a herniation of the anterior rectal wall into the posterior wall of the vagina. It is an acquired condition. This herniation begins as a gradual thinning of the rectovaginal septum, first noticeable just above the anal sphincter, and may extend as far as the rectovaginal pouch (Douglas cul-de-sac). A rectocele can be classified as low, midvaginal, or high. A rectocele can be a cause or a consequence of chronic constipation. Associated conditions include dyssynergic defecation, intussusceptions, cystocele, enterocele, or uterine prolapse.