Enterocele is a herniation of the small bowel through the posterior vaginal wall, classified as a form of pelvic organ prolapse. Surgical correction is the definitive approach to restore anatomical support.

Surgical Approach

Repair may be performed via a vaginal route — involving the vaginal apex and its supporting ligamentous attachments — or via an abdominal approach using mesh reinforcement to anchor the vaginal apex to the pelvis. The appropriate technique depends on the anatomical situation and extent of prolapse.

The full protocol specifies procedural selection criteria, concomitant repairs, and operative steps — all available through the link below.

References

DOI: 10.1097/AOG.0000000000003519

Vaginal hysterectomy and vaginal apex suspension with vaginal repair of anterior and posterior vaginal wall prolapse as needed are effective treatments for most women with uterovaginal and anterior and posterior vaginal wall prolapse.
Vaginal apex suspension involves attachment of the vaginal apex to the uterosacral ligaments or sacrospinous ligaments.
Abdominal sacrocolpopexy is a proven and effective surgery for the treatment of POP.
This procedure involves placement of a synthetic mesh or biologic graft from the apex of the vagina to the anterior longitudinal ligament of the sacrum.

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Surgical Treatment of Enterocele

References