An enterocele, also called small bowel prolapse, is a type of pelvic organ prolapse where the small intestine descends into the lower pelvic cavity and pushes against the upper part of the vaginal wall, causing the top of the vagina to bulge.
The muscles that support your pelvic organs may weaken because of childbirth, aging, and other factors that impose strain on the pelvic floor, making small bowel prolapse more likely. When you strain or bear down, an enterocele can grow larger and more visible during a bowel movement.
Self-care and other nonsurgical approaches are usually beneficial in treating mild bowel prolapse. In severe cases, surgery may be required to correct the prolapse. Because enteroceles are abnormalities of the pelvic supporting tissue rather than the intestinal wall, surgery to restore the vaginal wall is the most effective treatment.
What are the symptoms of an enterocele?
An enterocele may not cause symptoms until it has grown large enough to intrude into the vaginal canal. If you have a major prolapse, you may experience a sensation of fullness, achiness, or pressure in your pelvis, as well as painful intercourse and urinary incontinence. You may also experience lower back pain that goes away when you lie down.
What are the causes of an enterocele?
The main cause of pelvic organ prolapse is increased strain on the pelvic floor. Small bowel prolapse can be caused or exacerbated by the following conditions and activities:
- Pregnancy and labor
- Chronic coughing (due to bronchitis, asthma, or smoking)
- Lifting heavy objects on a regular basis
- Hysterectomy (removal of the uterus)
How is an enterocele diagnosed?
Our experienced gynecologist will perform a pelvic exam to confirm the diagnosis of small bowel prolapse. They may ask you to cough or take a deep breath and hold it while bearing down as if you were having a bowel movement, which will force the prolapsed small bowel to bulge downward and allow the gynecologist to feel the bulge. The doctor might also need to assess your pelvic floor muscles and look for prolapsed organs through imaging techniques such as a pelvic floor MRI or an ultrasound.
You should tell the doctor about any additional symptoms you’re experiencing because enterocele can develop in combination with other pelvic organ prolapses, such as bladder prolapse or urethral prolapse.
What are the treatments for enteroceles?
Small bowel prolapse can be treated in a variety of ways, depending on the severity of your condition, including:
If the symptoms aren’t bothering you, small bowel prolapse usually does not require treatment. If you want to avoid surgery, simple self-care procedures, such as completing Kegel exercises to strengthen your pelvic muscles, may help to alleviate symptoms. Anything that causes increased pelvic pressure should be avoided if you don’t want your condition to worsen.
You should consider Enterocele Repair surgery if you have advanced prolapse with bothersome symptoms. For this procedure, general anesthesia is used and you will most likely be asked not to drink or eat anything for 6–12 hours before the surgery.
Our gynecologist can repair a prolapse through the vaginal or abdominal canal. They will tighten and stitch the connective tissue in your pelvic floor to strengthen it and push the prolapsed small bowel back into place. The defect is repaired by suturing the supportive vaginal walls back together to prevent prolapse from returning. These sutures will merely heal the apical lesion; they will not secure the vaginal apex to a support structure.
Most patients who have undergone an enterocele repair also need a vaginal vault suspension. In many cases, the enterocele is further supported or repaired with the use of mesh. During the vaginal vault suspension procedure, the prolapsed vaginal vault is reattached to the higher regions of the ligaments (connected to the uterus) with permanent stitches or with the use of a synthetic mesh (a loosely woven sheet).
What should I expect after the enterocele repair procedure?
Depending on your condition, it will take 1 to 3 days to be discharged from the hospital. You will be able to resume your normal activities after around 6 weeks.
Your follow-up care is crucial to the success of your treatment. If you avoid smoking, getting pregnant, and heavy lifting, a recurrence of a minor bowel prolapse is uncommon. Your gynecologist will provide you with specific instructions to ensure proper healing and help strengthen pelvic floor muscles.
What should I do to prevent an enterocele?
To reduce your chances of developing an enterocele, you should avoid being constipated, carrying heavy objects, smoking, and being overweight.
Schedule your appointment at Novomed today
If you are experiencing enterocele symptoms, make an appointment with one of our highly qualified gynecologists to learn more about your condition and treatment options.
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