Enterocele and Rectocele Repairs

This information describes enteroceles and rectoceles and how they are repaired.

What is an enterocele (EN-tuh-roh-seel)?

An enterocele, also called small bowel prolapse, occurs when the small intestine moves down and pushes at the top part of the vagina. This creates a bulge (see Figure 1).

Figure 1: Enterocele

An enterocele can develop if the roof of the vagina is weak after surgery to remove the uterus. Other causes include:

  • Aging
  • Vaginal deliveries of heavy babies
  • Menopause
  • Previous hysterectomy
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What is a rectocele (REK-tuh-seal)?

A rectocele, also called a posterior prolapse, occurs when the rectum bulges into the back wall of the vagina (see Figure 2).

Figure 2: Rectocele

A rectocele is most often caused by weakened muscles in the vaginal wall. Other causes include:

  • Aging
  • Vaginal deliveries of heavy babies
  • Menopause
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What is a repair?

A repair is surgery in which the wall of the vagina is strengthened with stitches. An enterocele repair stops the small intestine from bulging into the vagina. A rectocele repair stops the rectum from bulging into the vagina.

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Are there any risks or complications associated with this surgery?

Although not common, the following complications can occur:

  • Pain
  • Bleeding
  • Infection
  • Injury to the bladder or ureters (tubes that take urine from the kidneys to the bladder)
  • Ongoing leakage of urine
  • Long-term or permanent problems urinating
    • You may have to insert a catheter into your bladder to drain your urine. You may also need another surgery to correct the problem.
  • The inability to hold urine until you reach a toilet
  • Narrowing of the vagina
  • With a rectocele repair, the bowel can become damaged and this can cause painful sexual intercourse
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What can I expect at the time of surgery?

  • The surgery will take 1 to 2 hours.
  • You will be asleep during the surgery.
  • Your surgeon will put absorbable stitches into the wall of your vagina. Your small intestine and rectum are not involved in the surgery.
  • Most patients go home the next day.
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What can I expect after my surgery?

  • You will have a gauze dressing in your vagina to help stop bleeding. The dressing will be removed the day after your surgery.
  • A thin tube will drain urine from your bladder while the area heals. Your doctor or nurse will remove it in 5 days. Please call the office to make the appointment. You will learn how to care for the tube before you go home.
  • Mild vaginal bleeding is common after surgery; make sure you have sanitary napkins. Do not use tampons.
  • You can shower 48 hours after your surgery. Do not take a bath or soak in a pool or hot tub until your doctor or nurse says it is safe.
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Will I have to take any medications after my surgery?

You will receive 3 medications:

  • An antibiotic that you must take until all the pills are gone
  • Medication to relieve pain after surgery
  • A stool softener to keep your bowels loose; stop taking it if you have diarrhea
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What instructions should I follow after my surgery?

  • Call your doctor if you have:
    • A temperature of 101° F (38.3º C) or higher
    • More vaginal bleeding than when you were in the hospital
    • Pain that is not relieved with your pain medication
    • Severe bladder spasms
    • Not had a bowel movement for more than 48 hours
    • Not passed gas for 24 hours
    • Nausea, vomiting, or both
  • Make an appointment to see your doctor 2 weeks after your surgery.
  • For 4 weeks after your surgery, avoid activity that will put stress on your abdomen (belly). Do not lift anything heavier than 10 pounds. Do not do any strenuous exercise.
  • Do not have sexual intercourse until your doctor says it’s okay.
  • Do not use tampons until your doctor says it’s okay.
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