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TYPES OF ENTEROCELE AND PRINCIPLES UNDERLYING CHOICE OF OPERATION FOR REPAIR

From the Department of Gynecology–Obstetrics, State University of New York at Buffalo and the Department of Obstetrics and Gynecology, Buffalo Hospital of the Sisters of Charity, 2157 Main St, Buffalo, NY 14214

Enterocele may occur with or without vaginal inversion or rectal prolapse. There is direct correlation between the four principal locations of enterocele and the four principal causes. Differential etiologic factors are discussed and correlated with specific surgical principles to permit a proper choice of corrective procedure. The various transvaginal and transabdominal surgical technics are mentioned and indications compared. The choice of operation is thus identified and selected preoperatively on a rational basis according to the etiologic factors in order to lessen the chances of recurrence. If enterocele is present but unrecognized and untreated at the time of pelvic surgery, progression of the lesion will often continue, with disability and discomfort. Many postoperative enteroceles are in fact extensions of an unrecognized and therefore untreated process already in progress at the time of original pelvic operation. A positive correlation is shown between type of enterocele, cause and choice of appropriate corrective procedure.