Videodefaecography allows identification of three different types of rectoceles: type I or digitiform rectocele, type II or rectocele with a lax rectovaginal septum, an anterior mucosal prolapse and a deep pouch of Douglas, and a type III in which a rectocele is associated with intussusception or even rectal prolapse. Furthermore, videodefaecography gave information on functional mechanisms resulting in incontinence or constipation. Surgical treatment should be tailored to the radiological and clinical findings: endoanal approach in type I, posterior colpomyorhaphy in type II and double abdomino-vaginal approach in type III. One hundred and fifty cases were prospectively treated according to this policy. Recurrence occurred in one out of 150 cases (1.3%). Incontinence was cured in 93% and constipation in 88%.