What is Enterocele?
Enterocele, also known as a small bowel hernia, is an example of a complication that effects women who have had a hysterectomy removing the entire uterus. It occurs when the pelvic organs, supported by various muscles and ligaments, stretch and weaken, allowing the small intestine to shift and fall into the vagina resulting in a bulge in the vaginal canal. The weakening can happen as a result from childbirth, excessive straining or age causing the pelvic organs to shift from their normal location.
Pelvic Cavity Post-Hysterectomy
Pelvic cavity with top of vagina collapsing.
The vaginal canal continues to collapse.
Small bowel has fallen into the collapsed vaginal canal.
Original Images Courtesy of BARD Medical – Subject to Copyrights. Labeling Enhanced for Educational Purposes by D. K. Veronikis, MD
Symptoms of Enterocele
Mild cases of Enterocele may not experience specific symptoms. However, in more severe cases you’re likely to notice vaginal discomfort or pain during intercourse. You may also notice a pulling or tugging sensation in your pelvis area or a feeling of pressure or pain. This pressure may also rest on other organs like the bladder causing symptoms of stress incontinence. The most prominent symptom for most patients is a soft bulge of tissue in the vagina.
Treatment for Enterocele
Enterocele treatment really depends on the severity of the condition. More mild cases benefit from Kegel exercise that strengthens the pelvic muscle tissues. For women who have experienced menopause, estrogen therapy may be beneficial as it helps keep the pelvic muscles strong. Additional nonsurgical options includes inserting pessary supports into the vagina. When surgery is required, it normally includes a reconstructive procedure that not only puts the small intestine and the vagina back in place, but it will also repair damage made to surrounding organs or tissue. These procedures can be performed using minimally invasive surgery techniques which reduces the recovery time experienced by a patient.