Difficulty or discomfort during a bowel movement, often marked by incomplete emptying or excessive straining, is common. Perineal splinting is a recognized physical technique that offers immediate relief by assisting the body in fully evacuating stool. This method provides temporary support for specific anatomical issues. This article explains the method, why it works, and when it indicates a need for professional medical evaluation.
What is Perineal Splinting and Why Does It Help?
Perineal splinting is the application of external or internal pressure to the wall separating the rectum and the vagina to facilitate a bowel movement. The term “perineal” refers to the tissue area between the vaginal opening and the anus, which is often where external pressure is applied.
The technique is effective because it counteracts a bulge in the rectal wall. When the tissue supporting the rectum weakens, the rectum can push forward into the back wall of the vagina. This creates a pocket where stool can become trapped, preventing it from following a straight path out of the body. Applying pressure acts as temporary support, pushing the bulging rectal wall back into proper alignment. By stabilizing this weakened area, splinting allows for easier and more complete evacuation without the need for harmful straining.
Step-by-Step Guide to Proper Splinting Technique
To begin, ensure you are in a relaxed position on the toilet. Using a footstool to elevate your knees above your hips helps relax the puborectalis muscle, which assists in maintaining continence. This elevated posture naturally straightens the anorectal angle, making passage easier.
To perform external splinting, apply gentle pressure to the perineum, the skin area just in front of the anus. You can use your fingers wrapped in toilet paper or a clean cloth. Press upward and slightly backward toward the spine to physically support the weakened wall.
For internal splinting, a clean, gloved finger or thumb is inserted just inside the vagina. The finger should then gently press backward toward the rectum and the tailbone. The pressure should be firm enough to stabilize the wall but never painful or forceful. Focus on relaxing the pelvic floor while applying the pressure.
Common Conditions That Require Splinting
The most frequent medical condition leading to the need for splinting is a rectocele, a specific type of pelvic organ prolapse. A rectocele occurs when the rectovaginal septum, the thin wall of tissue separating the rectum from the vagina, weakens. This allows the rectum to protrude into the vaginal canal.
Splinting is often necessary when the severity of the rectocele causes stool to become lodged in the resulting pocket, requiring manual assistance to push it past the obstruction. Other related issues, such as generalized pelvic organ prolapse, can also contribute to pelvic floor weakness that benefits from this support. Chronic, severe constipation with repeated straining is a common factor that weakens these support structures over time.
When Splinting Isn’t Enough: Seeking Professional Help and Long-Term Solutions
While perineal splinting offers immediate relief, it is considered a temporary aid and an indicator of an underlying issue, not a cure. If the frequency or intensity of required splinting increases, or if you experience pain, bleeding, or an inability to evacuate even with splinting, seek medical advice. A healthcare provider can properly diagnose the degree of pelvic organ prolapse or other cause of obstructive defecation.
Long-term management typically begins with conservative, non-surgical approaches focused on reducing strain on the pelvic floor. Maintaining optimal stool consistency through increased dietary fiber and adequate hydration is a foundational step. Pelvic floor physical therapy (PFT) is a primary non-surgical intervention that teaches patients exercises to strengthen and coordinate the pelvic muscles. For more severe cases, a pessary, a supportive device placed in the vagina, can provide mechanical support, or surgical repair may be considered to correct the anatomical defect.