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Prolapse | Small Intestine (Enterocele)

From the Pelvic Floor Articles List

Small intestine prolapse - what is this?I want to learn more about an enterocele and how it can be repaired.


Prolapse of the small intestine into the vagina is called an enterocele. This type of prolapse is considered a hernia of the pelvic floor that most often occurs in women who have had a hysterectomy; however, it may occur along with a rectocele even in women with a uterus. There are both surgical and non-surgical treatment options.

The upper walls of the vagina can weaken and separate, allowing the small intestine (or small bowel) to push into the vagina creating the enterocele. Besides a hysterectomy and/or rectocele, other risk factors can include pregnancy and vaginal delivery, natural aging, obesity, and prior pelvic surgery. Issues such as a chronic cough and straining with bowel movements can also be contributing factors.

Diagnosis can generally be made during a pelvic exam. Your doctor may perform the exam while you are lying down and while you are standing up. At times, a defocagraphy (x-rays during bowel movement) may be ordered.

While a minor enterocele may cause no symptoms, a more prominent one can be painful and affect bowel evacuation. Other symptoms can include vaginal bleeding or discharge, painful intercourse, and a feeling of pelvic heaviness. A pulling sensation or lower backache may also occur, but both tend to ease when lying down. You may also experience a bulge inside the vagina.

If the prolapse is minor and causing little or no symptoms, you may be able to follow expectant management. Another non-surgical option could be a pessary. As with most prolapse concerns, vaginal estrogen may be beneficial. Women with any prolapse concern should also avoid constipation, stay hydrated, and perform pelvic floor strengthening exercises. Any contributing health factors should be treated as well.

With surgical options, the goal is to move the bowel back into place, while also closing and strengthening the vaginal walls. Typically, this surgery is completed vaginally. If other prolapses exist, they should be treated concurrently.

Both a gynecologist and urogynecologist can treat an enterocele. The HysterSisters advocate seeking a second opinion to help you determine which treatment choice is best for you. Weigh your pros and cons and work with your medical team to develop the right plan for you.


This content was written by staff of HysterSisters.com by non-medical professionals based on discussions, resources and input from other patients for the purpose of patient-to-patient support.

06-11-2013 - 10:21 AM


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