Materiały źródłowe

• #1 Small bowel prolapse (enterocele) – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/enterocele/symptoms-causes/syc-20377661

  Small bowel prolapse (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. […] Small bowel prolapse, also called enterocele (EN-tur-o-seel), occurs when the small intestine (small bowel) descends into the lower pelvic cavity and pushes at the top part of the vagina, creating a bulge. The word „prolapse” means to slip or fall out of place. […] Childbirth, aging and other processes that put pressure on your pelvic floor may weaken the muscles and ligaments that support pelvic organs, making small bowel prolapse more likely to occur. […] Increased pressure on the pelvic floor is the main reason for any form of pelvic organ prolapse. […] Pregnancy and childbirth are the most common causes of pelvic organ prolapse. The muscles, ligaments and fascia that hold and support your vagina stretch and weaken during pregnancy, labor and delivery. […] Factors that increase your risk of developing small bowel prolapse include: […] You may be genetically prone to prolapse due to weaker connective tissues in your pelvic area, making you naturally more susceptible to small bowel prolapse and other types of pelvic organ prolapse.

• #2 Small bowel prolapse (enterocele) | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/small-bowel-prolapse-enterocele?content_id=CON-20377641

  Small bowel prolapse (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. […] Small bowel prolapse, also called enterocele (EN-tur-o-seel), occurs when the small intestine (small bowel) descends into the lower pelvic cavity and pushes at the top part of the vagina, creating a bulge. The word „prolapse” means to slip or fall out of place. […] Childbirth, aging and other processes that put pressure on your pelvic floor may weaken the muscles and ligaments that support pelvic organs, making small bowel prolapse more likely to occur. […] Increased pressure on the pelvic floor is the main reason for any form of pelvic organ prolapse. […] Pregnancy and childbirth are the most common causes of pelvic organ prolapse. The muscles, ligaments and fascia that hold and support your vagina stretch and weaken during pregnancy, labor and delivery.

• #3 Small bowel prolapse (enterocele) | UM Health-Sparrow

  https://www.uofmhealthsparrow.org/departments-conditions/conditions/small-bowel-prolapse-enterocele

  Small bowel prolapse, also called enterocele (EN-tur-o-seel), occurs when the small intestine (small bowel) descends into the lower pelvic cavity and pushes at the top part of the vagina, creating a bulge. The word „prolapse” means to slip or fall out of place. […] Childbirth, aging and other processes that put pressure on your pelvic floor may weaken the muscles and ligaments that support pelvic organs, making small bowel prolapse more likely to occur. […] Increased pressure on the pelvic floor is the main reason for any form of pelvic organ prolapse. Conditions and activities that can cause or contribute to small bowel prolapse or other types of prolapse include: Pregnancy and childbirth, Chronic constipation or straining with bowel movements, Chronic cough or bronchitis, Repeated heavy lifting, Being overweight or obese.

• #4 Enterocele – Birmingham Pelvic Floor Clinic

  https://birminghampelvicfloorclinic.com/conditions/entorecele/

  Enterocele or sigmoidocele is a type of prolapse or internal hernia. It is a bulge that develops between the vagina in front and the rectum behind. The small intestine (enterocele) or colon (sigmoidocele) pushes downwards between the vagina and rectum causing pressure on each. […] Enteroceles or sigmoidoceles usually occur as a result of damage to the tissues between the rectum and vagina during childbirth. The tearing leads to a weakness in the tissues and with time a bulge develops. Enterocele or sigmoidocele may also develop in women who have to strain excessively to open their bowels. […] Enterocele or sigmoidocele are also more common in women who have had a hysterectomy. This may be due to weakness at the top of the vagina caused by the hysterectomy itself. […] Enteroceles and sigmoidoceles may be associated with other pelvic floor weaknesses that include internal prolapse (intussusception), rectoceles and anal incontinent symptoms.

• #5 Enterocele – Wikipedia

  https://en.wikipedia.org/wiki/Enterocele

  An enterocele is a herniation of a peritoneum-lined sac containing small intestine through the pelvic floor, between the rectum and the vagina (in females). Enterocele is significantly more common in females, especially after hysterectomy. […] Several factors are thought to be involved in the development of enterocele, such as age, multiple pregnancies, previous pelvic surgery, excessive pelvic floor descent, weakened pelvic floor, long term chronic straining. Enteroceles can form after treatment for gynecological cancers. Hysterectomy or urethropexy increase the rectovaginal space and reduce support from adjacent organs. This is thought to promote the development of an enterocele. […] Different pelvic floor defects may co-exist with enterocele. About 40% of patients with external rectal prolapse or internal rectal prolapse (rectal intussusception) also have enterocele. In some cases, an enterocele may prolapse externally along with an external rectal prolapse. It is not clear in such situations if the enterocele caused or aggravated the rectal prolapse, or if the pouch of Douglas is merely pulled down by the rectal prolapse. It is thought that enterocele may initiate or aggravate an internal rectal prolapse. The hernia may descend into and impinge upon the rectal wall.

• #6 Pelvic Prolapse: Diagnosing and Treating Cystoceles, Rectoceles, and Enteroceles – Page 6

  https://www.medscape.com/viewarticle/722323_6

  An enterocele is essentially a vaginal hernia in which the peritoneal sac containing a portion of the small bowel extends into the rectovaginal space between the posterior surface of the vagina and the anterior surface of the rectum. […] Enteroceles have been placed into 4 categories based on the mechanism of acquisition: congenital, iatrogenic, traction, and pulsion. Congenital enteroceles are extremely rare and occur when incomplete fusion of the rectovaginal septum leaves an open cul-de-sac. Iatrogenic enteroceles typically occur following procedures that alter the vaginal axis, such as those used for the treatment of stress urinary incontinence. The probable mechanism of an iatrogenic enterocele is an anterior and vertical rotation of the vaginal axis that allows the normally closed cul-de-sac to open and become unprotected.

• #7 Enterocele – Diagnosis, Treatment, and Repair – Midwest Center for Pelvic Health

  https://www.midwestpelvis.com/enterocele-repair/

  Enterocele is a specific type of pelvic organ prolapse that occurs when the small intestine pushes on the vaginal walls causing a bulge or protrusion. […] The word enterocele literally means hernia of the small bowel. […] When the connective tissues of the vagina become weak or injured, enterocele and other types of pelvic organ prolapse may occur. […] Enterocele is a type of pelvic organ prolapse in which the small intestine pushes on or against the vaginal wall and causes a bulge or protrusion of the vagina.

• #8 Enterocele | Abdominal Key

  https://abdominalkey.com/enterocele/

  A brief review of the key supporting structures and potential spaces within the pelvis is important in understanding enterocele defects and in serving as a guide to the appropriate repair. […] Defects in the pubocervical, endopelvic, and rectovaginal fasciae are the root cause of organ prolapse. […] Failure of any, or a combination, of these levels will cause vaginal vault prolapse and allow the small bowel to occupy the potential space between the vagina and rectum, producing a posterior enterocele. […] The distinct apical enterocele will occur when the endopelvic fascia overlying the vaginal cuff is disrupted and/or thinned, typically during hysterectomy. […] This leads to further attenuation of Denonvilliers fascia, widening of the Pouch of Douglas, and deepening of the enterocele as symptoms continue to worsen. […] The development of symptoms occurring after hysterectomy should alert the clinician to the possibility of an apical enterocele as the causative agent.

• #9 Enterocele, Rectocele, or Both? — APOPS

  https://www.pelvicorganprolapsesupport.org/sherriepalm-articles/enterocele-rectocele-or-both8302017

  Symptoms of an enterocele may be sensation of a mass bulging into the vagina or pushing against the perineum or pain with intercourse. They may also include a pulling sensation in the pelvis or low back pain that eases up when you lie down, vaginal discharge, or a feeling of pelvic fullness, pain, or pressure. There may be a rapid return of bowel movement urge shortly after evacuating bowels (gotta go, gotta go again). […] There are 4 types of enterocele: Pulsion: Caused by continual pressure in abdomen from chronic cough or extreme physical exertion like repetitive heavy lifting. […] Traction: Caused by pregnancy, childbirth and estrogen loss which contribute to weakening and stretching of pelvic tissues. Additionally other prolapsed organs may put pressure on tissues contributing to enterocele.

• #10 ENTEROCELE, RECTOCELE, OR BOTH?

  https://www.linkedin.com/pulse/enterocele-rectocele-both-sherrie-palm

  There are 4 types of enterocele: Pulsion: Caused by continual pressure in abdomen from chronic cough or extreme physical exertion like repetitive heavy lifting. Traction: Caused by pregnancy, childbirth and estrogen loss which contribute to weakening and stretching of pelvic tissues. Additionally other prolapsed organs may put pressure on tissues contributing to enterocele. Latorgenic: Cause is not fully known but assumed to be related to hysterectomy or some cystocele repair procedures. Congenital: Birth defect. […] An additional and more definitive diagnostic tool utilized for enterocele is called DRE or defecography (also called proctography). During this test, the act of defecation is assessed by recording expulsion of barium paste that is the consistency of feces. This test can evaluate pelvic floor and rectal function, how well the rectal sphincter works, and the effectiveness of rectal evacuation.

• #10 ENTEROCELE, RECTOCELE, OR BOTH?

  https://www.linkedin.com/pulse/enterocele-rectocele-both-sherrie-palm

  Enterocele occurs when the intestines (small bowel) protrude through a fascial defect or weak tissues, typically at the apex (top) of the vagina. Women whove experienced birth trauma or had prolonged deliveries or forceps deliveries may have a higher risk of enterocele. Patients with previous pelvic surgery may have a predisposition to an enterocele as well; particularly a hysterectomy. […] An enterocele can develop in the posterior wall (back side by rectum) or anterior wall (front side by uterus), basically wherever the small bowel (intestines) fall through defects in the vaginal wall. The size and degree of drop of enteroceles may vary considerably, from halfway down the vaginal length, all the way down to the perineum (tissues surrounding the urogenital and anal openings), or even protrude out of the anal canal to form rectal prolapse.

• #11 Enterocele, Rectocele, or Both? — APOPS

  https://www.pelvicorganprolapsesupport.org/sherriepalm-articles/enterocele-rectocele-or-both8302017

  Latorgenic: Cause is not fully known but assumed to be related to hysterectomy or some cystocele repair procedures. […] Congenital: Birth defect. […] An additional and more definitive diagnostic tool utilized for enterocele is called DRE or defecography (also called proctography). During this test, the act of defecation is assessed by recording expulsion of barium paste that is the consistency of feces. This test can evaluate pelvic floor and rectal function, how well the rectal sphincter works, and the effectiveness of rectal evacuation.

• #12 Small bowel prolapse (enterocele) – Vejthani Hospital | JCI Accredited International Hospital in Bangkok, Thailand.

  https://www.vejthani.com/diseases-conditions/small-bowel-prolapse-enterocele/

  The small intestine (small bowel), also known as enterocele, descends into the lower pelvic cavity and pushes on the top part of the vagina, resulting in the bulging of the bowel. Prolapse refers to the act of slipping or falling. […] The muscles and ligaments that support your pelvic organs may get weaker as a result of childbirth, aging, and other processes that increase pressure in the abdominal cavity. This increases the likelihood of small bowel prolapse. […] Small bowel prolapse happens when the connective tissue is damaged or weakened. The pelvic muscles can deteriorate due to several reasons, such as: […] Pelvic organ prolapse is commonly caused by pregnancy and childbirth. During pregnancy, labor, and delivery, the muscles, ligaments, and tissue that hold and support your vagina stretch and deteriorate.

• #12 Small bowel prolapse (enterocele) – Vejthani Hospital | JCI Accredited International Hospital in Bangkok, Thailand.

  https://www.vejthani.com/diseases-conditions/small-bowel-prolapse-enterocele/

  Your risk of experiencing small bowel prolapse is affected by the following factors: […] With advancing age, small bowel prolapses and other pelvic organ prolapse become more frequent. You typically lose muscle mass and strength as you age, including in your pelvic muscles as well as other muscles. […] Smokers regularly cough, which raises abdominal pressure, which increases the risk of prolapse. […] Your risk of prolapse rises as a result of the weakened pelvic floor support structures caused by one or more vaginal deliveries. […] Surgery treatment to cure incontinence or removal of your uterus (hysterectomy) may increase your risk of developing small bowel prolapse. […] Being overweight puts more pressure on your internal organs, which raises the possibility of small bowel prolapse.

• #13 Small bowel prolapse (enterocele)

  https://www.mymlc.com/health-information/diseases-and-conditions/s/small-bowel-prolapse-enterocele2/

  Pregnancy and childbirth are the most common causes of pelvic organ prolapse. The muscles, ligaments and fascia that hold and support your vagina stretch and weaken during pregnancy, labor and delivery. […] Factors that increase your risk of developing small bowel prolapse include: Pregnancy and childbirth. Vaginal delivery of one or more children contributes to the weakening of your pelvic floor support structures, increasing your risk of prolapse. The more pregnancies you have, the greater your risk of developing any type of pelvic organ prolapse. […] Small bowel prolapse typically doesn’t need treatment if the symptoms don’t trouble you. Surgery may be effective if you have advanced prolapse with bothersome symptoms. Nonsurgical approaches are available if you wish to avoid surgery, if surgery would be too risky or if you want to become pregnant in the future.

• #14 Enterocele, Rectocele, or Both? — APOPS

  https://www.pelvicorganprolapsesupport.org/sherriepalm-articles/enterocele-rectocele-or-both8302017

  Enterocele occurs when the intestines (small bowel) protrude through a fascial defect or weak tissues, typically at the apex (top) of the vagina. Women whove experienced birth trauma or had prolonged deliveries or forceps deliveries may have a higher risk of enterocele. Patients with previous pelvic surgery may have a predisposition to an enterocele as well; particularly a hysterectomy. […] An enterocele can develop in the posterior wall (back side by rectum) or anterior wall (front side by uterus), basically wherever the small bowel (intestines) fall through defects in the vaginal wall. The size and degree of drop of enteroceles may vary considerably, from halfway down the vaginal length, all the way down to the perineum (tissues surrounding the urogenital and anal openings), or even protrude out of the anal canal to form rectal prolapse.

• #15 Small bowel prolapse (enterocele)

  https://www.mymlc.com/health-information/diseases-and-conditions/s/small-bowel-prolapse-enterocele2/?section=Prevention

  Pregnancy and childbirth are the most common causes of pelvic organ prolapse. The muscles, ligaments and fascia that hold and support your vagina stretch and weaken during pregnancy, labor and delivery. […] Factors that increase your risk of developing small bowel prolapse include: Pregnancy and childbirth. Vaginal delivery of one or more children contributes to the weakening of your pelvic floor support structures, increasing your risk of prolapse. The more pregnancies you have, the greater your risk of developing any type of pelvic organ prolapse. Women who have only cesarean deliveries are less likely to develop prolapse. Age. Small bowel prolapse and other types of pelvic organ prolapse occur more often with increasing age. As you get older, you tend to lose muscle mass and muscle strength — in your pelvic muscles as well as other muscles. Pelvic surgery. Removal of your uterus (hysterectomy) or surgical procedures to treat incontinence may increase your risk of developing small bowel prolapse. Increased abdominal pressure. Being overweight increases pressure inside your abdomen, which increases your risk of developing small bowel prolapse. Other factors that increase pressure include ongoing (chronic) cough and straining during bowel movements. Smoking. Smoking is associated with developing prolapse because smokers frequently cough, increasing abdominal pressure. Race. For unknown reasons, Hispanic and white women are at higher risk of developing pelvic organ prolapse. Connective tissue disorders. You may be genetically prone to prolapse due to weaker connective tissues in your pelvic area, making you naturally more susceptible to small bowel prolapse and other types of pelvic organ prolapse.

• #16 Enterocele – Pelvic Floor Center

  https://pelvicfloorcenter.org/enterocele/

  Factors that increase your risk of developing small bowel prolapse include: Pregnancy and Childbirth: Vaginal delivery of one or more children contributes to the weakening of your pelvic floor support structures, increasing your risk of prolapse. The more pregnancies you have, the greater your risk of developing any type of pelvic organ prolapse. […] Age: Small bowel prolapse and other types of pelvic organ prolapse occur more often with increasing age. As you get older, you tend to lose muscle mass and muscle strength — in your pelvic muscles as well as other muscles. […] Increased Abdominal Pressure: Being overweight increases pressure inside your abdomen, which increases your risk of developing small bowel prolapse. Other factors that increase pressure include ongoing (chronic) cough and straining during bowel movements.

• #17 Enterocele (Small Bowel Prolapse): Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/16966-enterocele

  An enterocele occurs when part of the small intestine drops (prolapses) into the pelvic area. The small intestine (or small bowel) pushes against the top of the vagina, causing a bulge. Another name for enterocele is small bowel prolapse. Its a type of pelvic organ prolapse that affects the female reproductive system. […] An enterocele occurs when muscles, connective tissues and ligaments in the pelvic region (pelvic floor) stretch or tear. These muscles and tissues support the bowels, uterus and vagina. […] The small intestine then presses against the upper wall of the vagina. […] Your risk of developing an enterocele increases during and after menopause when estrogen levels drop. Estrogen helps keep pelvic muscles strong. […] Other conditions that weaken pelvic floor muscles and cause enteroceles include: Pregnancy and childbirth. Chronic coughing from conditions like bronchitis or asthma or smoking. Connective tissue disorders like Ehlers-Danlos syndrome.

• #18 Enterocele | Pelvic Angel

  https://www.pelvicangel.net/enterocele

  An enterocele is the protrusion of the small bowel pushing into the upper wall of the vagina. It can also be defined as a hernia of the peritoneal sac, which contain the small bowel or sigmoid colon protrusion. Muscles and ligaments that support your small intestine can become weak and cause it to descend into the vagina. There enterocele will bulge into the vagina. […] Childbirth can cause the pelvic floor muscles to become stretched or weakened, especially women who have multiple or difficult childbirths, which can lead to an enterocele. […] Constipation, heavy lifting, chronic cough can also be causes of an enterocele. […] A decrease in oestrogen levels can cause the pelvic floor muscles to weaken and as a result may result the organs to descend (prolapse).

• #19 Pelvic Prolapse: Diagnosing and Treating Cystoceles, Rectoceles, and Enteroceles – Page 6

  https://www.medscape.com/viewarticle/722323_6

  Traction enteroceles are relatively common and are usually found in conjunction with uterine prolapse, cystocele, and rectocele. […] Lastly, a pulsion enterocele can occur secondary to conditions that cause chronically raised intra-abdominal pressure, such as chronic cough or severe physical exertion. […] A large number of enteroceles occur after hysterectomy, typically when obliteration of the cul-de-sac and vaginal reapproximation of the supporting structures were not performed. A good vaginal suspension and cul-de-sac obliteration are prophylactic and should prevent the later occurrence of an enterocele. […] Once an enterocele has been identified, the 4 principles of enterocele repair are to (1) identify the enterocele and probable etiology by careful preoperative evaluation; (2) mobilize or obliterate the enterocele sac; (3) occlude the sac with suture ligation as high as possible; and (4) close the hernia defect by providing support below the hernia sac and restore the normal vaginal axis.

• #20 Constipation and Pelvic Prolapse: How They’re Related

  https://www.healthline.com/health/womens-health/constipation-and-pelvic-prolapse

  Constipation may be both a symptom and cause of pelvic organ prolapse. Weakened pelvic floor muscles can increase the risk of both. […] A rectocele is the type of pelvic organ prolapse that’s most likely to be linked to constipation. […] Constipation can be a risk factor for pelvic organ prolapse, and it can also be a symptom. Pelvic organ prolapse can make it hard for your body to pass stool. This can worsen constipation or cause new constipation. […] Constipation can cause pelvic organ prolapse. Most often, a type of prolapse called rectocele happens when the rectum pushes into the vagina.

• #21 Small Bowel Prolapse or Enterocele – Symptoms, Prevention & Treatment

  https://www.apollohospitals.com/diseases-and-conditions/small-bowel-prolapse-or-enterocele-symptoms-causes-prevention-and-treatment/

  Small bowel prolapse, also called enterocele, is an abnormal condition where the small intestine slides into the lower pelvic cavity making a bulge on the top part of the vagina. […] Aging, childbirth, or other processes may impact ligaments and tissues that hold pelvic organs. They may weaken your muscles that in turn makes small bowel prolapse a probability. […] Pregnancy or childbirth: Although pregnancy or childbirth may not always result in a small bowel prolapse. The muscles, ligaments and fascia that hold and support your vagina stretch and weaken during pregnancy, labor and delivery. This condition may further spiral into the enterocele. […] Severe constipation or strain in bowel movements also creates pressure on the pelvic floor that may evolve into small bowel prolapse. […] Overweight or obesity is one of the other causes of small bowel prolapse. […] Negligence of small bowel prolapse may lead to ulcers, Gangrene, bleeding, and strangulated rectum which is a medical emergency. […] Although vaginal prolapse has the least impact on metabolic functions, depending on the extent, it may or may not interfere with digestive functions.

• #22 Vaginal enterocele after cystectomy: A case report

  https://www.wjgnet.com/2307-8960/full/v10/i6/2045.htm

  In the present case, the patient had a long history of constipation with vaginal enterocele occurring during defecation and a large, hard fecal mass was palpable in the sigmoid colon on intraoperative exploratory laparotomy. We believe that constipation is a high-risk factor for acute vaginal enterocele. Therefore, it is important to correct constipation problems, and we recommend routine bowel preparation before surgery and propose individualized postoperative bowel movement management protocols for patients with a history of constipation.

• #22 Vaginal enterocele after cystectomy: A case report

  https://www.wjgnet.com/2307-8960/full/v10/i6/2045.htm

  After undergoing radical cystectomy combined with hysterectomy, female patients may suffer from pelvic organ prolapse due to the destruction of pelvic structures, which mainly manifests as the prolapse of tissues of varying degrees in the vulva and can be accompanied by symptoms, such as bleeding and inflammation. Once this complication is present, we need surgical intervention to resolve it. So how to prevent and manage this complication is especially important. […] The postoperative occurrence of acute enterocele is rare, and a case of acute small bowel vaginosis 2 mo after radical cystectomy with hysterectomy is reported. […] After undergoing radical cystectomy combined with hysterectomy, female patients may suffer from POP due to the destruction of pelvic structures. If the patient presents vaginal bacteria proliferation, damage to pelvic internal tissues due to inflammation resulting in edema can result in acute vaginal enterocele.

• #23 Enterocele – Pelvic Floor Center

  https://pelvicfloorcenter.org/enterocele/

  Smoking: Smoking is associated with developing prolapse because smokers frequently cough, increasing abdominal pressure. Also, smokers may have problems with healing of damaged connective tissues, which can contribute to prolapse. […] You may be genetically prone to prolapse due to weaker connective tissues in your pelvic area, making you naturally more susceptible to small bowel prolapse and other types of pelvic organ prolapse.

• #24 Enterocele and sigmoidocele – The Midlands Bowel Clinic

  https://themidlandsbowelclinic.com/diagnosis/enterocele-and-sigmoidocele/

  An enterocele or sigmoidocele is a type of pelvic organ prolapse or internal hernia. It occurs when the small intestine (enterocele) or colon (sigmoidocele) pushes downwards between the vagina and rectum, creating a bulge that can cause pressure and discomfort. […] The main cause of an enterocele or sigmoidocele is weakness or damage to the pelvic floor tissues, particularly in the area between the rectum and vagina. Common risk factors include: […] Enteroceles and sigmoidoceles are often associated with rectoceles, internal prolapse (intussusception), and anal incontinence symptoms. […] For women experiencing significant pressure symptoms or difficulty emptying their bowels, surgery may be recommended. The type of repair depends on whether other pelvic floor issues or prolapse are present. […] If the enterocele is the primary issue, surgery may be performed through the vagina, often in collaboration with a gynaecologist. […] If internal rectal prolapse coexists, this minimally invasive procedure may be considered.

• #25 Small bowel prolapse (enterocele) // Middlesex Health

  https://middlesexhealth.org/learning-center/diseases-and-conditions/small-bowel-prolapse-enterocele

  Removal of your uterus (hysterectomy) or surgical procedures to treat incontinence may increase your risk of developing small bowel prolapse. […] You may be genetically prone to prolapse due to weaker connective tissues in your pelvic area, making you naturally more susceptible to small bowel prolapse and other types of pelvic organ prolapse. […] A surgeon can perform surgery to repair the prolapse through the vagina or abdomen, with or without robotic assistance. During the procedure, your surgeon moves the prolapsed small bowel back into place and tightens the connective tissue of your pelvic floor.

• #26 Vaginal enterocele after cystectomy: A case report

  https://www.wjgnet.com/2307-8960/full/v10/i6/2045.htm

  We have summarized the etiology of acute enterocele based on reported cases as follows: (1) Patients were discharged from the hospital with mixed hygiene strategies and occasionally lacked the necessary perineal care, had vaginal bacteria proliferation, had damage to pelvic internal tissues due to inflammation resulting in edema, and had difficulties in securing vaginal posterior wall sutures due to edema and the weakened state of inflammatory tissues (which result in slippage of sutures); (2) As was found in the patients in these cases, a history of constipation was present in some patients with increased pressure in the pelvic cavity during bowel movements leading to enterocele; and (3) Clinicians mainly focus on tumor recurrence and prognosis, and reexamination is mainly based on imaging and biochemical examination. Reexamination often lacks a meticulous physical examination, and early enterocele is easily overlooked.

• #27 Enterocele (Small Bowel Prolapse): Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/16966-enterocele

  There are nonsurgical and surgical treatments for enteroceles. […] Treatments for an enterocele include: Pessary to support the pelvic floor muscles. […] Surgery to move the small intestine back into place and repair stretched or torn tissues. […] Nonsurgical treatments often relieve enterocele symptoms. Some women who arent having problems dont need any treatment. An enterocele rarely causes serious problems.

• #28 Enterocele with Risk of Intestinal Incarceration: A Case Report

  https://www.scientificarchives.com/article/enterocele-with-risk-of-intestinal-incarceration-a-case-report

  Enterocele is a hernia of the small bowel into the vagina, because the peritoneal sac containing small bowel or omentum extends into the rectovaginal space that separates the vagina from the rectum. […] The management of these patients aims to reduce prolapse in order to improve their quality of life. […] Urgent intervention is rarely required, but in cases where the enterocele is associated with small bowel obstruction and cannot be reduced, emergency surgical treatment would be indicated to try to avoid intestinal necrosis and systemic infection. […] The diagnosis of advanced enterocele with risk of intestinal obstruction is a very rare but potentially serious clinical case. The immediate recognition and management are very important because of the risk of vaginal rupture, intestinal necrosis, and also systemic infection.

• #29 Enterocele with Risk of Intestinal Incarceration: A Case Report

  https://www.scientificarchives.com/article/enterocele-with-risk-of-intestinal-incarceration-a-case-report

  Small bowel obstruction as a complication of an enterocele is very rare. Although it may manifest as incomplete emptying of the rectum, the only symptom significantly associated with enterocele is vaginal prolapse itself. […] It should be noted that prolapse reduction was possible thanks to preoperative management with the patient being placed in the Trendelenburg position together with the application of local ice to the perineum. In this way the tissues were in a better condition to be repaired. […] Due to the total eversion of the vagina, in addition to hysterectomy, anterior colporrhaphy and closure of the peritoneal hernia, fixation of the vaginal vault to the right sacrospinous ligament was performed, in order to reduce the risk of subsequent recurrence. […] The diagnosis of advanced enterocele with risk of bowel obstruction or even ischemia is a very rare but potentially serious event due to the risk of bowel necrosis, systemic infection or evisceration after vaginal rupture. Its immediate recognition and management are very important for patients with this clinical presentation. Ideally, it would be desirable to first reduce the congested structures in order to manage the tissues in the best possible conditions.

• #30 Enterocele (Small Bowel Prolapse): Symptoms & Treatment | Qwark

  https://qwarkhealth.com/conditions/enterocele-small-bowel-prolapse

  Enterocele, also known as small bowel prolapse, is a rare condition where a portion of the small intestine protrudes into the pelvic cavity. […] Chronic constipation can be a contributing factor in the development of Small Bowel Prolapse, but the condition is often caused by other factors, such as childbirth, aging, and previous surgeries. […] Pregnancy can lead to Enterocele due to the increased weight and pressure placed on the pelvic floor muscles and ligaments. […] A weakened pelvic floor can contribute to the development of Enterocele. […] Enterocele is a condition that can progress over time resulting in the bowel protruding into the vaginal wall. […] Yes, Enterocele can lead to serious health complications such as infection, bowel obstruction, and difficulty in emptying the bowel and bladder.

• #30 Enterocele (Small Bowel Prolapse): Symptoms & Treatment | Qwark

  https://qwarkhealth.com/conditions/enterocele-small-bowel-prolapse

  Yes, the severity of Enterocele can influence the overall prognosis of the individual. […] Yes, early detection of Enterocele is critical for a positive prognosis. […] Factors such as age, the severity of the condition, associated medical conditions, and response to treatment can contribute to a poorer Enterocele prognosis. […] Preventive measures for Enterocele primarily involve strengthening the pelvic floor muscles. […] Diet and exercise can play an essential role in preventing Small Bowel Prolapse. […] Regular pelvic floor exercises can be highly beneficial in preventing Enterocele. […] Avoiding heavy lifting can help reduce the risk of Small Bowel Prolapse. […] Certain lifestyle changes can help prevent Enterocele, including maintaining a healthy weight, stopping smoking, and avoiding constipation.

• #31 Vaginal Rupture and Evisceration in a Patient With Chronic Rectocele: A Case Report and Literature Review | Cole | Journal of Current Surgery

  https://www.currentsurgery.org/index.php/jcs/article/view/393/376

  While uterine prolapse is relatively common in elderly women, occurring in up to half of women over the age of 50, the incidence of evisceration from the prolapse is low. […] In general, historic and anatomic factors predisposing to vaginal evisceration regardless of menopausal status include prior pelvic surgery, the presence of an enterocele, particularly posterior enterocele, vaginal cuff defects, and coital trauma. Post-menopausal women are at increased risk of rupture due to atrophic and relatively weaker vaginal tissue than that in pre-menopausal women. […] While increased straining and prolapse have a higher incidence of evisceration, the presence of an enterocele in postmenopausal women further increases their risk of rupture and evisceration. This is likely secondary to the enterocele causing increased pressure on an already weakened atrophic vaginal tissue.

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