I would agree with your doctor that you should see an Urogynecologyist and be evaluated. A bulge in the posterior (bottom) vaginal wall can be from the rectum (rectocele), small intestines (entrocele) or both. Diagnosis is most often made by pelvic examination, which includes rectal exam as well as vaginal exam. You are correct in stating that examination as compared to surgical findings is correct in approximately 60% of cases. This however is not of great concern because both rectocele and enterocele can be repaired at the time of surgery. Most patients will have more than one defect.
As far as confirmatory testing, Defecography (a radiology study done with contrast material) and Dynamic MRI (a special Magnetic Resonance Imaging technique) can be used to differentiate between a rectocele, enterocele, and other pelvic floor disorders (fallen bladder, etc.) These are highly specialized test often not available in smaller medical centers.
Hopefully you will be able to be seen soon. Thank you for your question. J. Kyle Mathews, MD
Thank you for your answer. It was helpful. I hope to find out what is wrong before I am operated on so I can look at my choices. Am unable to stand or stay upright for too long at present due to pressure on my bladder from bowel ( I am slim though ) .
I hope to see someone soon but dont know when.