There are currently two main treatments for proctal protrusion, namely conservative treatment and surgical treatment. Conservative treatment is mainly based on medication, diet structure and biofeedback to achieve symptom relief and is suitable for mild patients. Since 80% of asymptomatic women can have proctal protrusion, how to determine the relationship between proctal protrusion and constipation directly determines the effectiveness of surgical treatment. There are four main types of surgical treatment: transrectal, transvaginal, transperineal and transabdominal approaches to repair and strengthen the rectovaginal septum. However, the surgical operation is more complicated, and the adjacent tissues are damaged during the operation, and postoperative complications such as infection, bleeding, and even rectovaginal fistula are likely to occur. From the analysis of the available data, the effect of surgical repair is the most unpredictable of all constipation surgeries, and 30% to 72% of patients still have different degrees of defecation difficulties after surgery. Therefore, it is of great importance to explore a safe, effective, simple and stable treatment method with long-term efficacy. The anterior rectal wall in women is supported by the rectovaginal septum, which is mainly composed of the intrapelvic fascia (peritoneal perineal fascia, i.e., Denonvilliers fascia) and is generally about 0.5 cm thick; the center of the fissure of the levator muscle (often the lowest point of the funnel-shaped levator muscle) is the normal physiological position of the rectovaginal septum, and the supporting tissues in the fissure are weak, while the levator muscle in women and the elderly has a wider fissure. The anterior side of the anus in women lacks the support of strong sphincter muscles, so the anterior side is more likely to be damaged by the impact of the horizontal fraction of feces going down, and because the lower part of the anterior rectal wall is often overstretched, the rectovaginal septum thins, some muscle fibers break, the anterior rectal wall elongates, the perineal body drops, and a hernia-like rectal protrusion forms during defecation. Because of poor defecation, the prolonged defecation and the pushing of dry and hard stool on the mucous membrane layer of the intestinal wall cause the rectal mucosa to be removed, and the mucous membrane is accumulated in the middle and lower rectum, which makes the intestinal cavity relatively narrow and aggravates poor defecation. At the same time, the mucosa of the vaginal wall is stretched and vaginal laxity occurs. Transvaginal repair alone only strengthens the rectovaginal septum without dealing with the comorbidities, thus the efficacy is poor; intrarectal surgery can deal with the comorbidities at the same time, but it is not easy to take care of them after surgery, and it is easy to have infection and cause rectovaginal fistula. Therefore, we applied “transvaginal repair” to treat both the cause and the comorbidities. This method not only repairs the muscular layer, eliminates the anterior rectal pouch, but also strengthens the weak area, reinforces the rectovaginal septum, reduces the perineal descent, forms a barrier to support the anterior wall of the rectum, reduces the excessive stretching and pulling of the vaginal septum and vaginal nerves, thus improving the mechanical angle at the anal canal during the downward movement of feces, and restores the normal defecation function so that the defecation is smooth. After long-term clinical application and follow-up, the long-term effect is confirmed.