A rectocele occurs when the thin wall of fibrous tissue (fascia) that separates the rectum from the vagina weakens, allowing the vaginal wall to bulge. It is usually the front wall of the rectum that bulges into the back wall of the vagina. Surgical repair comprises of dissecting the rectum off the vagina, reducing the rectal prolapse and reinforcing the tissues between the vagina and the rectum. This procedure is called posterior vaginal wall repair.