Enterocele

Enterocele (Bowel Prolapse) – Comprehensive Guide

What is Enterocele?

Enterocele is the prolapse of the small intestines towards the posterior wall of the vagina. It usually occurs as a result of weakening of the pelvic floor support tissues.

What Causes It?

• Multiple vaginal births
• Pelvic surgeries (especially hysterectomy)
• Menopause (decreased estrogen)
• Chronic constipation and straining
• Pelvic floor weakness

Symptoms

• Feeling of fullness or pressure in the vagina
• Sensation of a mass
• Lower back and groin pain
• Symptoms worsening after prolonged standing

Difference from Other Prolapses

Unlike rectocele, enterocele contains small bowel and is usually seen in the upper vaginal segment.

Diagnosis

• Gynecological examination
• Pelvic assessment
• Imaging if necessary (MRI, defecography)

Treatment Options

1. Observation (in mild cases)
2. Pelvic floor exercises
3. Vaginal pessary
4. Surgical treatment

Surgical Treatment

• Vaginal or abdominal approach
• Sacrocolpopexy
• Vaginal vault support
The aim is to lift and support the intestines.

Who Needs Surgery?

• Advanced prolapse
• Significant symptoms
• Conditions affecting daily life

Prevention

• Pelvic floor exercises
• Avoiding constipation
• Avoiding heavy lifting
• Weight management

Clinical Fact

Enterocele often occurs with other pelvic organ prolapses (cystocele, rectocele).

Conclusion

Enterocele is a treatable condition. Successful outcomes are achieved with correct diagnosis and appropriate surgery.