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NBME 24 Answers
An 80-year-old woman, gravida 4, para 4, comes to ...
Damage to the rectovaginal septum
Rectal prolapse through posterior vagina ("rectocele").
"When a rectocele becomes large, stool can become trapped within it, making it difficult to have a bowel movement or creating a sensation of incomplete evacuation. Symptoms are usually due to stool trapping, difficulty passing stool, and protrusion of the back of the vagina through the vaginal opening. During bowel movements, women with large, symptomatic rectoceles may describe the need to put their fingers into their vagina and push back toward the rectum to allow the stool to pass (“splinting”). Rectoceles are more common in women who have delivered children vaginally."
really like the pubic hair....