An enterocele or small bowel prolapse occurs when the tissues and muscles that hold the small bowel in place are stretched or weakened. It may develop if the muscles in a woman's vaginal canal become damaged by pregnancy, labor, childbirth, or a previous pelvic surgery or are weakened by aging. In rare cases, it can be present at birth (congenital).
An enterocele may become large or more obvious when a woman strains or bears down (for example, during a bowel movement). It may cause a heavy feeling in the vagina, constipation, or incomplete emptying of the bowel. Some women experience a pulling or aching feeling in the low back or pelvis that may be more noticeable after standing for a long time.
Exercises to strengthen the pelvic floor muscles, called Kegel exercises, may help relieve some symptoms of enterocele. In severe cases, surgery may be needed.
Why is repair of rectocele or enterocele done?
Surgical repair of rectoceles and enteroceles is used to manage symptoms such as movement of the intestine that pushes against the wall of the vagina, low back pain, and painful intercourse. An enterocele may not cause symptoms until it is so large that it bulges into the midpoint of the vaginal canal.
Rectocele and enterocele often occur with other pelvic organ prolapse, so tell your doctor about other symptoms you may be having. If your doctor finds a bladder prolapse (cystocele), urethral prolapse (urethrocele), or uterine prolapse during your pelvic exam, that problem can also be repaired during surgery.
What are the risks of repair of rectocele or enterocele?
Risks of rectocele and enterocele repair are uncommon but include:
- Urinary retention.
- Bladder injury.
- Bowel or rectal injury.
- Painful intercourse.
- Formation of an abnormal connection or opening between two organs (fistula).
What can you expect as you recover from repair of a rectocele or enterocele?
General anesthesia is usually used for repair of a rectocele or enterocele. You may stay in the hospital from 1 to 2 days. Most women can return to their normal activities in about 6 weeks. Avoid strenuous activity for the first 6 weeks. And increase your activity level gradually.
Normal bowel function returns within 2 to 4 weeks. It is important to avoid constipation during this time. Your doctor will give you special bowel care instructions. But it is important to include sources of fiber and adequate fluids in your diet. Try to drink about 6 to 8 glasses of water a day.
Most women are able to resume sexual intercourse in about 6 weeks.