Pelvic Organ Prolapse: Surgery for Rectocele and Enterocele

The organs in the pelvis are supported by structures around them. Things like aging and childbirth can cause these structures to weaken. Loss of support lets pelvic organs fall out of their normal position. This is called prolapse. If the rectum falls out of place and bulges into the vagina, it's called rectocele. If the small intestine falls out of place and bulges into the vagina, it's called enterocele. Surgery can be done to fix these problems. This will help relieve your symptoms.

Side view cross section of female pelvis showing rectum sagging into vagina, called rectocele.

The surgical procedure

  • To correct a rectocele, the rectum is moved back to its normal position. The tissue between the vagina and rectum is stitched (sutured) to strengthen it. This stops the rectum from bulging into the vagina.

  • To correct an enterocele, the small intestine is moved away from the vagina. Excess tissue is then stitched. This holds it in place.

  • Sometimes a synthetic material or biologic graft is used in the process of correcting the defect.

Your incisions

During surgery, the doctor reaches your pelvic organs through the vagina or the abdomen. If going through the vagina, incisions may be made in the wall of the vagina. If the surgery is through the abdomen, several small incisions may be used to perform laparoscopic surgery. Or one larger incision either up and down (vertical) or across (transverse) may be used.

Risks of surgery

  • Infection

  • Bleeding

  • Risks of anesthesia

  • Damage to nerves, muscles, or nearby pelvic structures

  • Blood clots

  • Prolapse of the pelvic organ or organs occurring again

  • Fistula. This is an abnormal connection from the bowel to the vagina.

Online Medical Reviewer: Daniel N Sacks MD
Online Medical Reviewer: Donna Freeborn PhD CNM FNP
Online Medical Reviewer: Heather Trevino
Date Last Reviewed: 6/1/2020
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