We are both 64 years old. She told me a week or so ago that she thought she might have a UTI because she was feeling some irritation similar to what she has had before with those. Later, she told me that she was feeling something strange in her vulva and asked me to look at it.
What I was seeing LOOKED like something protruding through the surface (skin) of the vestibule (ie, between her inner labia), between her clitoris and urethral opening, well in front of her vaginal opening. It is much darker and purplish, very different from the skin of the vestibule. It was not a bulge under the skin, but looked as though the surface tissues had split open and something internal (bladder?) was poking through. It was about 3/8" in diameter and protruding about 1/4". Using her inner labia, I could push what was protruding back in and it would take a few seconds for it to return to protruding. It SEEMS like it is a hernia that is not only poking through the abdominal wall, but also through the surface of her vestibule. Doing research online, I found plenty of references to hernias which occur generally in that area, but seem to normally end up showing up within the outer labia and not being exposed as this apparently is. Yes, I do wish I had taken a picture! As some background, she has always had trouble with control/strength of her pelvic floor muscles, so they are likely fairly weak.
I encouraged her to get an appointment with her PCP doctor, which she did, but was seen by a new-ish doctor in the practice so that she wouldn't have to wait a few days to see her usual doctor. This doctor told her it looked as though she had a prolapsed uterus, which totally baffles me as I felt no evidence of this with my finger when I was checking it out initially. I also have had experience with someone who has had a prolapsed uterus and that was very clearly evident in the vagina or at the opening of the vagina. This protrusion was a good inch forward of the vaginal opening. This doctor sent her to get a transvaginal ultrasound, but the technician performing that was only 'looking' for problems with the uterus and likely did not even see the actual problem herself (because she didn't know about it because my wife didn't make sure the technician understood what her complaint was, relying on her doctor having given reasonable instructions). The ultrasound did not show anything remarkable 'little change from previous exam'. Back to the doctor who saw her in the first place who spoke of using a pessary to support the uterus and also, thankfully, set her up with a referral to a gynecologist whom she will see thursday.
To me, this seems as though it is a risky and scary thing to be happening; if it truly is a protrusion of some internal part of her abdominal cavity (and her bladder seems like it is about all it could be), it seems as though there is a significant risk of infection into the abdominal cavity. I have been totally unable to find anything described that is similar to this on the web, other than anal fissures and some of the pictures of those look very similar to this when they are coupled with a hernia at the same site. So I might call this a vestibular fissure with hernia.
Has anyone heard of or experienced anything like this before? Am I right that this (assuming I am interpreting what I am seeing correctly!) is potentially much more serious than a prolapsed uterus? I am hoping that the gynecologist she will be seeing can correctly identify what is happening and explain it to my wife and propose a correction for it (which, I am assuming, would require surgery to repair the hernia and close the fissure). Unfortunately, I can't be there with her as I am over 4 hours away from home; I will give her some specific things to point out the the gynecologist and questions to ask; any suggestions about what I might be missing here to help get this resolved?
Thanks for helping out a guy worried about his wife.
---Edited to add in a picture:
I am noticing that the protrusion is bigger than it was a few days ago.
Thanks for the inputs so far!