Enterocele occur primarily in patients who have had their uterus removed (hysterectomy). The anterior vaginal wall (pubocervical) fascia and posterior vaginal wall (rectovaginal) fascia separate and intestines can push directly against the vaginal skin. The herniation at the apex of the vagina is known as an enterocele.
Enterocele Figure: 1
Normal Support - no enterocele
Enterocele Figure: 2
Enterocele - There exists a defect between the pubocervical fascia and rectovaginal fascia (note - the intestine are pushing directly against the vaginal epithelium)
Patients with a large enterocele, vaginal vault prolapse and uterine/vaginal prolapse may experience:
Pelvic or vaginal pressure
Difficulty evacuating rectum
Difficulty emptying bladder
Dyspareunia (painful intercourse)
Lower back pain/discomfort
Increasing pain/discomfort with prolonged standing
