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Enterocele

What is Enterocele?

When the wall between the rectum and the vagina is weakened, the small bowel can descend into this weakened area. This results in a small bowel prolapse, or enterocele. At Loma Linda University Health, we offer minimally invasive enterocele treatment options that allow a rapid return to normal activities.

What are the symptoms of enterocele?

The symptoms of enterocele may include:

  • A bulging feeling in the vagina or perineum (between the vulva and anus)
  • Pressure or pain in the pelvis or vagina
  • Urinary incontinence
  • Constipation and incomplete bowel movements
  • Stool leakage or urgency
  • Pain during intercourse
  • A pulling sensation in the pelvis or lower back that eases when you lie down
  • Vaginal discharge

What causes enterocele?

In addition to genetics, causal factors for enterocele include:

  • Hysterectomy  
  • Multiple childbirths, specifically in older or obese women
  • Menopause
  • Extreme physical activity
  • Heavy lifting
  • Obesity
  • Chronic constipation
  • Chronic cough (including smoker’s cough)

How is enterocele diagnosed?

Enterocele is typically diagnosed by a pelvic exam. Other tests may be run to measure how well each of the pelvic organs is working.

How is enterocele treated?

An enterocele may be treated conservatively and does not require surgery unless symptoms are interfering with a patient’s quality of life. Patients can experience good results from:

  • Kegel exercises
  • Avoiding heavy lifting
  • Avoiding getting constipated
  • Losing weight
  • Quitting smoking to minimize coughing
  • Using a vaginal pessary, an inserted device designed to support the bulging tissue

If enterocele surgery is needed, it is often performed at the same time with the repair of either a rectocele or vaginal and/or rectal prolapse. Typically, it involves the closure and reinforcement of the rectovaginal septum (the wall between the rectum and vagina). The surgeon moves the prolapsed small bowel back into place and tightens the connective tissue of the pelvic floor. Sometimes, small portions of synthetic mesh may be used to help support weakened tissues.

What are the complications of enterocele?

Complications of enterocele surgery are rare, but can include:

  • Urinary retention
  • Bladder injury
  • Bowel or rectal injury
  • Infection
  • Painful intercourse
  • Formation of a fistula

Who is at risk for enterocele?

Those most at risk for enterocele?

  • Women who have had multiple childbirths
  • Women who have had a hysterectomy
  • Women who have entered menopause
  • Women who are overweight
  • Women who smoke
  • Women who have enterocele in their family history

NEXT STEPS

Seek medical intervention. If you are experiencing symptoms of enterocele, seek medical help. Request an evaluation by contacting your provider, or schedule the appointment through MyChart.