Shauna Lorenzo-Rivero, MDQ: There is a bulge in my vaginal area and I have difficulty evacuating my stools. What is this?
A: There may be several explanations. The most common is a rectocele, a bulge of the rectum into the vagina. The rectal wall may become thinned and weak and may balloon out into the vagina, especially when having a bowel movement. But the bladder and the small intestine may also bulge into the vagina. The underlying cause of a rectocele is a weakening of the pelvic support structures and thinning of the wall between the rectum and vagina. In addition, a history of constipation and straining with bowel movements or a hysterectomy may contribute to its development. Many women have rectoceles, but only a small percentage have symptoms, which include vaginal bulging, the sensation of a mass in the vagina, pain with intercourse or even something hanging out of the vagina You should consider having your rectocele treated when it causes significant symptoms. Options include a pessary (plastic tampon that holds organs in place) and transanal or transvaginal repair.
– Shauna Lorenzo-Rivero, MD, University Surgical Associates; member, Chattanooga-Hamilton County Medical Society
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