[5] The phenomenon is caused by a weak section of fascial supports of the vagina (the uterosacral cardinal ligament complex and rectal vaginal septum), which allows a section of peritoneum containing the sigmoid colon to prolapse out of normal position and descend between the rectum and the vagina.
This structure is very flexible, which means that the sigmoid colon is very mobile and may change position.
[1] Surgery is considered if there is a significant hernia combined with symptoms of obstructed defecation.
This acts to support the recto-vaginal septum and elevate a deep pouch of Douglas.
[9] Other treatment options are anterior resection,[4] sigmoidopexy with rectocele repair,[4] or sigmoidectomy.