Vaginal Splinting and Bowel Movements

Vaginal splinting is the term used to describe the process in which a woman uses her fingers to press on the vagina to help ease stool out of the rectum. This is typically done when a woman is constipated or experiences incomplete evacuation (the sensation that the bowel has not been cleared even if it has).

This article explains what is involved with vaginal splinting and describes some of the medical conditions in which vaginal splinting may be used to help empty the bowel.

A woman with smartphone sitting on the toilet
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What Is Vaginal Splinting?

Sometimes it is difficult to have a bowel movement without straining.  Over time, straining can cause the weakening of the pelvic floor and associated problems like pelvic organ prolapse (POP). Vaginal splinting is one way to help move the stool out of the anal canal when it cannot be passed naturally.

Vaginal splinting is a form of digital evacuation ("digital" referring to fingers). It involves placing fingers into the vagina and pressing against the back wall to help ease stool out of the rectum. To do this, the woman would feel around the back wall for a bulge and use her fingers to gently move the stool toward the anal canal.

While vaginal splinting is commonly performed with fingers, a tampon can also be used to apply pressure to the back wall of the vagina.

There are other ways to manually overcome constipation. This includes massaging the buttock and/or perineum (the diamond-shaped area between the anus and vagina) or performing digital disimpaction (in which fingers are inserted into the anus to help remove stool).

Recap

Vaginal splinting is performed by inserting fingers into the vagina and gently pressing against the back wall in a downward motion. This helps ease stools out of the rectum.

Conditions Associated With Vaginal Splinting

Women often resort to splinting as a way to compensate for the changes in the anatomy and function of the pelvic organs.

There are various conditions for which vaginal splinting may be needed to remove stool, three of which involve the prolapse (bulging) of the pelvic organs. These include:

  • Cystocele: The bulging of the bladder into the vagina
  • Dyssynergic defecation: The dysfunction of the pelvic floor muscles and nerves that regulate bowel clearance
  • Enterocele: The bulging of the bowel into the vagina and rectum
  • Rectocele: The bulging of the wall of the rectum into the vagina

Recap

Vaginal splinting is often used when defecation is affected by the pelvic organ prolapse or by problems affecting the muscles and nerves of the pelvic floor (referred to as dyssynergic defecation).

What Research Says

It is estimated that 20% of women experience problems with bowel movements on an ongoing basis.

A 2012 study published in Female Pelvic Medicine and Reconstructive Surgery evaluated 29 women using magnetic resonance imaging (MRI) to get a better understanding of how digital evacuation is used to treat chronic defecation problems in females. An MRI is an imaging technology that is especially good at visualizing soft tissues.

What they found was that 59% of the participants used vaginal splinting as a means to clear stools from the rectum. Another 31% used perineal massage, while 10% used buttock massage to help pass stools.

Based on the MRI results, the researchers also found that the participants had one or more conditions that directly interfered with bowel evacuation. The causes broke down as follows:

  • Rectocele: 86.2%
  • Cystocele: 75.9%
  • Enterocele: 10.3%
  • Dyssynergic defecation: 17.2%

Recap

Research suggests that the majority of women with chronic defecation problems use vaginal splinting as the main form of digital evacuation.

Summary

Vaginal splinting is a procedure in which fingers are inserted into the vagina to manually manipulate stool out of the rectum. It is done by feeling around for a bulge in the back of the vagina and gently pressing in a downward motion to help ease the stool out of the body.

Vaginal splinting may be used to relieve occasional constipation but is more commonly used when a woman experiences pelvis organ prolapse or experiences dysfunction of the muscles and nerves to help regulate bowel movements.

A Word From Verywell

If you need to use your fingers to help pass stools, it is important that you bring this to your healthcare provider's attention. They can help identify the underlying cause and discuss which course of treatment will work best for you. Do let embarrassment keep you from getting the relief you need.

Frequently Asked Questions

  • Is constipation more common in women?

    Yes. Women are three times more likely than men to have bouts of constipation. Women have an even greater risk if they’re older adults, lead an inactive lifestyle, consume fewer calories than recommended, and eat a low-fiber diet.

  • What is digital disimpaction?

    Digital disimpaction involves the manual removal of stools from the anus. It is often performed with anal douching to help ease the passing of stools. Digital disimpaction can cause problems like rectal bleeding and hemorrhoids, so speak with your doctor if your constipation is bad enough to require digital disimpaction as there are likely better solutions.

  • Can you pass stool out of the vagina?

    If you have a rectovaginal fistula, an abnormal opening between the rectum and the vagina, stool might very well leak out of the vagina. You also might notice gas, mucus, and an unpleasant odor. Any infection needs to be treated, and surgery may be needed to close the opening.

6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Apostolis C, Wallace K, Sasson P, Hacker MR, Elkadry E, Rosenblatt PL. Assessment of women with defecatory dysfunction and manual splinting using dynamic pelvic floor magnetic resonance imaging. Female Pelvic Med Reconstr Surg. 2012;18(1):18-24. DOI:10.1097/SPV.0b013e31823bdb98

  2. Steele SR, Mellgren A. Constipation and obstructed defecation. Clin Colon Rectal Surg. 2007;20(2):110–117. doi: 10.1055/s-2007-977489

  3. Apostolis, C., et. al. "Assessment of Women With Defecatory Dysfunction and Manual Splinting Using Dynamic Pelvic Floor Magnetic Resonance Imaging" Female Pelvic Medicine & Reconstructive Surgery 2012 18:18-24.

  4. Apostolis C, Wallace K, Sasson P, Hacker MR, Elkadry E, Rosenblatt PL. Assessment of women With defecatory dysfunction and manual splinting using dynamic pelvic floor magnetic resonance imaging. Female Pelvic Med Reconstr Surg. 2012 Jan-Feb;18(1):18–24. doi:10.1097/SPV.0b013e31823bdb98

  5. Jamshed N, Lee Z-E, Olden KW. Diagnostic approach to chronic constipation in adults. AFP. 2011;84(3):299-306.

  6. Kniery KR, Johnson EK, Steele SR. Operative considerations for rectovaginal fistulas. World J Gastrointest Surg. 2015;7(8):133–137. doi:10.4240/wjgs.v7.i8.133

By Barbara Bolen, PhD
Barbara Bolen, PhD, is a licensed clinical psychologist and health coach. She has written multiple books focused on living with irritable bowel syndrome.