Age 53, premenopause, missed period in July, had urethral sling surgery, now with rectal bulge, and very scared.

[Beabun]

Hot flashes for a few years, much more lately, anxiety due to premenopause, night sweats.  Now a small bulge that protrudes from the rectum while urinating without straining and with BM.  It retracts afterwards.  No pain, itching, bleeding or any discomfort.  Had a midurethral sling surgery 2 months ago with no complications or problems as of yet.  At my 6-week visit with urologist, she did not see anything and said it was not related to surgery. I first noticed the bulging about 4 weeks after the surgery.  Could it really be an internal hemorrhoid even though it protrudes during urination without straining? As I am careful not strain, as urologist told me to, as I'm still healing from that surgery.  I have my annual gyn appt. in September so will ask about this bulge then.  But I'm also so nervous about this that I'm trying to figure out what it is and get any info. I can to have ready for my appt.  Do you think this could be related to the surgery?  Uro. gave me stool softeners for 1 month after surgery to prevent any straining.  Should I keep taking such medicine because I don't really strain for bowels anyhow?  Could it be possible that this bulge will not be visible or palpable at the time of gyn visit, even if I tell her about it, no matter what it is.  Is there a way for me to be sure if its hemorrhoid or prolapse? Could it be related to menopause at all?

[Machelle Seibel, MD]

Without an exam, it is difficult to know what is the cause of your problem. However, a bulge from your rectum is most likely a hemorrhoid.  When you go for your gyn exam, tell the doctor. He/She might ask you to push down like a bowel movement to see if it comes out. That is the easiest way to tell. If not, see a gastroenterologist. They will do a proctoscope which is putting a small telescope into the rectum and they can look at it directly. Usually this is done in the office.It is unlikely something to worry about but probably the gyn and definitely the gastroenterologist will be able to tell you what it is.
Machelle M. Seibel, MD