Enterocele – Diagnosis and Treatment

Diagnosis

Doctors usually start by doing a pelvic check to spot signs of pelvic organ prolapse, such as enterocele or other related issues like cystocele and rectocele.

During the exam, the patient may take a deep breath and press down, which can make a bulge in the vaginal area more noticeable.

Sometimes, the doctor repeats the exam while the patient stands to help spot any movement of the uterus, vaginal wall, or bladder.

Common tools and steps include:

• Pelvic examination
• Valsalva maneuver
• Checking for symptoms like pelvic pressure, incontinence, or pain

In some cases, doctors use imaging tests like magnetic resonance imaging (MRI) to get a clearer look at pelvic floor disorders, vaginal vault prolapse, or urinary retention.

Treatment

Several choices exist for managing small bowel prolapse, depending on the severity of symptoms and individual health needs. When symptoms are mild or not bothersome, doctors may suggest regular monitoring and self-care.

Treatment Option	Purpose	Notes
Observation and Exercise	Mild symptoms, preventive care	Regular Kegels, avoid lifting
Pessary	Structural support	Needs fitting and cleaning
Surgery	Advanced repair	May use mesh; several approaches
Physical Therapy	Strengthen pelvic muscles	Often part of non-surgical care
Colpocleisis	Closure procedure for select patients	Chosen when other options fail

Simple actions such as Kegel exercises help strengthen the pelvic muscles. Avoiding heavy lifting and preventing constipation can keep the problem from getting worse. If a patient needs more support, doctors may recommend a pessary.

Healthcare providers fit this device, made of silicone, plastic, or rubber, inside the vagina to give extra support to the affected tissues. Patients learn how to care for and use the device at home.

Doctors may suggest surgery for those with severe or advanced symptoms. Surgeons can operate through the vagina or abdomen, and sometimes use robotic assistance for more precise repair.

The surgeon moves the prolapsed bowel back into its normal position and secures the pelvic tissues.

Occasionally, surgeons use synthetic mesh for additional support in the pelvic area. In complex cases, doctors may consider hysterectomy or other pelvic surgery, especially if other organs are involved or if a fistula forms.

Physical therapy helps some people improve pelvic strength without surgical intervention.

While infections, such as urinary tract infections, may happen with any treatment, good self-care and regular follow-ups help prevent further problems.

If needed, doctors may consider other surgical methods like colpocleisis, especially for those not planning future pregnancies.

Everyday Habits and Self-Care Strategies

Kegel exercises help build up the muscles of the pelvic floor. These muscles support important organs such as the uterus, bladder, and bowel. Keeping them strong can improve symptoms and help prevent further problems.

To do Kegel exercises:

• Find the right muscles. Use the muscles that stop the flow of urine.
• Contract and relax. Tighten these muscles for five seconds, then relax for another five seconds. If this feels hard, start with shorter times, such as two seconds tightening, then three seconds relaxing.
• Increase over time. Gradually work toward holding each squeeze for 10 seconds.
• Repeat regularly. Try for at least three sets of 10 squeezes each day.

Biofeedback can help some people. This technique uses special devices to show if the right muscles are being tightened.

Physical therapists teach the correct way to do Kegels and give feedback to make sure the exercises are working as they should.

Kegel exercises can be practiced quietly in many places. They do not require special equipment and can fit easily into daily routines, such as while watching TV or sitting at a desk.

Tip: If unsure about which muscles to use or how to do these exercises, ask a healthcare provider for advice. They may suggest biofeedback or further support from a professional.

Getting Ready for Your Visit

Steps You Can Take Before Your Visit

Preparing before meeting with a healthcare provider for small bowel prolapse or related concerns can be helpful. Here are some useful ways to get ready:

• Write down your symptoms. Note if you have issues like constipation, difficulty urinating, painful intercourse, or vaginal bleeding. Include details about how long these symptoms have been present and if they have changed over time.
• Record your medical history. Make a list of your past pregnancies, any vaginal deliveries, chronic constipation, or problems such as obesity. Include any surgeries—especially relating to childbirth, pelvic organs, or anesthesia use.
• List your medications. Write down all prescriptions, over-the-counter drugs, vitamins, and supplements that you use.
• Bring support. Ask a trusted family member or friend to come with you. They can help remember details or provide support, especially if you feel worried or have trouble recalling information.
• Prepare questions to ask the provider:
  • Is my small bowel prolapse causing my current symptoms?
  • Which treatment options do you think are right for me?
  • What are the risks if I don’t get this treated now?
  • How likely is it that this could return in the future?
  • Should I avoid lifting heavy objects or making certain movements?
  • Are there self-care tips or exercises I can do at home—for example, Kegels?
  • Do I need to see a different type of specialist, such as a urogynecologist?

If any new symptoms arise before your appointment—such as sudden pain, fever, or heavy bleeding—make sure to add these as well. Keep your questions handy so you can refer to them during your visit.

Topics Your Provider Might Discuss with You

During your appointment, the provider or specialist will likely ask questions to better understand your condition. This helps them recommend the most effective treatments.

Some common questions include:

• What symptoms are you having?
• When did each symptom start, and has anything gotten worse?
• Are you experiencing pelvic pain, painful intercourse, or vaginal bleeding?
• Do movements like coughing, lifting, or straining during bowel movements make it worse?
• Do you have problems like constipation, chronic cough, or urine leakage?
• Have you gone through pregnancy and vaginal delivery before?
• Are you hoping to have children later?
• Do you have any other health conditions, such as obesity or issues related to anesthesia?
• What medications, vitamins, or supplements do you currently use?

Open, honest answers will help your provider give the best advice.