29th April 2024

A 58-year-old woman presents with a sensation of a bulge in her vagina, which worsens by the evening and after prolonged standing.

A 58-year-old woman presents with a sensation of a bulge in her vagina, which worsens by the evening and after prolonged standing. She has a history of four vaginal deliveries and a hysterectomy 10 years ago. On examination, there is a visible protrusion at the vaginal introitus, which increases on straining. She has no urinary incontinence or rectal symptoms.

Which is the most likely diagnosis?