Brief Answer:
You probably have prolapse of your bladder or rectum

Detailed Answer:
Hello, and I hope I can help you today.

First of all, i want you to know that your symptoms are very typical for a condition a gynecologist can diagnose and treat, and that you should not be embarrassed as there are many women in your situation.

The bulge you feel coming out of your vagina is likely a condition called a cystocele, a rectocele, or some combination of the two. A good image and summary of the condition is available at the following link:

http://www.mdguidelines.com/cystocele-or-rectocele

A cystocele or rectocele is a bulge (or hernia) of the skin of the inside of the vagina that backs up on your bladder (the organ right above your vagina) or your rectum (which is right below your vagina). Many women who have had multiple vaginal deliveries may have some stretching of the skin of the inner vaginal walls that can be pushed out of the vagina if you bear down (push) to try to urinate or pass gas or stool. Many women describe the feeling of a ball stuck in the opening of the vagina, which sticks out most if you are standing up or pushing down while sitting on the toilet. Some women also have incontinence along with it (losing urine when you cough, sneeze, laugh or lift heavy objects)

If you can push the ball back inside your vagina (which is easiest when you are lying on your back) it is not an emergency, especially if you are able to urinate. Women who have bad prolapse (the term for the bulge that sticks out) actually need to push the ball back into the vagina while on the toilet in order to urinate or defecate. So as long as you can pass urine, it is not an emergency that you need to seek care for immediately.

A gynecologist, or a gynecological specialist who also treats female incontinence (called a urogynecologist) is the proper type of physician you should see to properly diagnose and treat you. Vaginal prolapse can be treated with non-surgical measures and also with surgery. One of the simplest ways some women manage the bulge is to push it back inside and insert a tampon- which can help hold the bulge back inside. A device called a peasary is a rubber or silicone disk, ring or other shaped object that is worn inside the vagina to hold the bulge in. For a more permanent solution, surgery can be performed to tighten the skin of the vagina and remove the bulge.

I think if you look at the link I supplied, and search the terms prolapse, cystocele, rectocele, or anterior/posterior repair (which is the typical surgical procedure used to treat the condition) you will acquire enough information to be reassured that you are not alone, and that your condition is treatable. The best next step would be to schedule an appointment with a gynecologist, preferably a gynecological surgeon or incontinenece specialist.

The only reason you should go to the ER is if you cannot urinate at all and/or push the bulge back inside. Otherwise, this is a common condition that is very treatable and there is no reason you should feel embarrassed as most GYN doctors have seen and treated women with prolapse.

I know this is a lot of information, but I hope I was able to adequately answer your question today and that this information was helpful. Please do lot hesitate to contact me if I can clarify anything or if you need and further advice.

Best wishes,

Dr. Brown

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