A 55-year-old woman presents with a sensation of a bulge in the upper posterior vaginal wall and difficulty in evacuation requiring digital pressure on the posterior vaginal wall to pass stool. The most likely diagnosis is:
- A Enterocele
- B Vault prolapse
- C Rectocele ✓
- D Uterine prolapse
Correct answer: C. Rectocele
Explanation
Rectocele presents with a posterior vaginal wall bulge and obstructed defecation, often requiring digital splinting (digital pressure on the posterior vaginal wall) to aid stool evacuation. Enterocele also involves the upper posterior wall but is less commonly associated with defecatory dysfunction. Vault prolapse occurs after hysterectomy. Uterine prolapse involves descent of the cervix, not isolated posterior wall symptoms.
Reference: Bailey and Love's Short Practice of Surgery, 28th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.