Pelvic Bulges Explained: Rectum or Small Intestine?

This resource addresses pelvic bulges (pelvic organ prolapse), which affect up to half of women who have had children. It focuses on two conditions: Rectocele (the rectum bulges forward into the vagina, a problem from the side) and Enterocele (the small intestine pushes down into the space, a type of internal hernia, a problem from above). Diagnosis relies on symptoms, as small rectoceles can be present in up to 93% of asymptomatic women. The gold standard test is Defecography, a specialized X-ray video that records the pelvic floor in action while the patient simulates a bowel movement to check the size of the bulge and if it traps stool. Surgery is recommended based on severe symptoms (e.g., needing to press on the vaginal wall to empty the bowels). Rectocele repair strengthens the weakened wall. Enterocele often requires a different procedure, such as a Sacrocolpopexy, to lift and secure the pelvic organs.