An enterocele (EN-tur-o-seel) is a vaginal hernia, which occurs when your small intestine (small bowel) descends into the lower pelvic cavity and pushes at the top part of your vagina, creating a bulge. Enteroceles most commonly occur in women who have had surgery to remove the uterus (hysterectomy).
Childbirth and aging may weaken the muscles and ligaments (pelvic floor) that support your bladder, uterus, colon and small intestine. The weakening may cause one or more of these organs to drop (prolapse). Enterocele is one condition that can result from weakening pelvic floor structures.
For a mild or moderate enterocele, nonsurgical treatments — particularly, exercises to strengthen your pelvic floor muscles — may help relieve symptoms, if symptoms are present. More severe cases of enterocele may require surgery to fix the condition.
An enterocele occurs when muscles and tissues that hold the intestines (small bowel) in place inside the pelvic cavity weaken, causing the small bowel to descend and bulge into the vagina. ...
A mild enterocele may produce no signs or symptoms. However, if you have a severe enterocele, you may experience the following:
When to see a doctor
Enterocele and prolapse of other pelvic organs often results from a combination of factors, including:
Factors that increase your risk of developing an enterocele include:
Preparing for your appointment
To evaluate pelvic organ prolapse, your first appointment may be with your primary care provider. However, in some cases when you call to set up an appointment, you may be referred directly to a doctor who specializes in conditions affecting the female reproductive tract (gynecologist).
Here's some information to help you prepare for your appointment and what to expect from your doctor.
What you can do
For enterocele, some basic questions to ask your doctor include:
In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions during your appointment if you don't understand something.
What to expect from your doctor
Tests and diagnosis
You'll need a pelvic exam to confirm a diagnosis of an enterocele. With a speculum in the vagina, your doctor may ask you to take a deep breath and hold it while bearing down (Valsalva maneuver), which is likely to cause the prolapsed small bowel to bulge downward. If your doctor can't verify that you have an enterocele while you're lying on the examining table, he or she may repeat the exam while you're standing.
Treatments and drugs
Mild cases of enterocele may require no treatment. Surgical repair may be most effective in more severe cases, particularly when an enterocele is accompanied by other types of pelvic organ prolapse. Nonsurgical approaches are also available if you're not interested in surgery, if surgery would be too risky for you or if you want to bear more children.
In most cases, the surgical approach is through your vagina. In this procedure, your surgeon puts the prolapsed small bowel back into place and tightens the muscles and ligaments of your pelvic floor.
Surgical repair of an enterocele is more common when other prolapsed organs, such as the uterus, bladder or rectum, are involved. In those cases, hysterectomy and repairs of the cystocele and rectocele can be done at the same time as the enterocele repair.
With proper technique during surgical repair, an enterocele usually doesn't recur.
Pessaries come in many shapes and sizes. The device fits into your vagina and provides support to vaginal tissues displaced by pelvic organ prolapse. Your doctor can fit you for a pessary and help ...
Lifestyle and home remedies
Kegel exercises can help improve the overall strength of your pelvic floor muscles and may help alleviate some of the symptoms of pelvic organ prolapse, such as pelvic pressure, urinary incontinence or fecal incontinence.
You can do these exercises almost anytime — while watching television, talking on the telephone or sitting at your desk.
To perform Kegel exercises:
If you have trouble with Kegel exercises, consider asking your doctor for help. Many women find it difficult to isolate the pelvic floor muscles. Your doctor can show you the right muscles and proper technique for Kegel exercises. You might also benefit from the help of a physical therapist, who uses special training devices to help you identify and isolate your pelvic floor muscles for strengthening.
You may be able to prevent an enterocele by doing the following:
Last Updated: 2010-06-05
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