Re: ENTEROCOELE/RECTAL PROLAPSE
From: Harvey S. Marchbein, M.D. (anonymous@obgyn.net)
Sat, 3 Mar 2001 22:56:51 -0600 (CST)
At this point I'd see a urognecologist to evaluate the enterocele and
see if it indeed is the cause of any present problems.
Hope this helps and write back anytime for more information.
HSM
At Fri, 2 Mar 2001, Veronica wrote:
>
>I've had no children, yet, and prolapse trouble, affecting the bowel,
>bladder and low pelvic pain. Had a sigmoidcolectomy and rectopexy for
>rectal prolapse and before this a rectal operation for a solitary rectal
>ulcer. Lately had a defecogram done -
>
>At rest the apex of the rectum lies approximately 4cm below the
>pubo-coccygeal line and the ano-rectal angle is 123 degrees. The
>vaginal tampon is bent upon itself. Abnormal descent of the vagina and
>loops of small bowel appear to pass through the peroneal hiatus but the
>vagina appears to be displaced and rotated laterally. There is a small
>anterior rectocoele during straining. On voiding the apex of the rectum
>goes to approx. 7.5cm below the pubococcygeal line and the ano-rectal
>angle decreased to approx. 110 degrees. Moderate laxity of the pelvic
>floor and an apparent enterocoele.
>
>I was to have a Delorme procedure and the day before the defecogram.
>Still had the Delorme...
>
>Was sent to a Physiotherapist, who gave me pelvic floor exercises. Still
>have bladder frequency and bowel problems. Was told to use a
>suppository every morning and not to push or strain.
>
>Could the enterocele cause all the trouble? (seems like it to me). The
>surgeon has not said anything about it so maybe it is okay (if I don't
>strain). If problems continue should I go back to the Colorectal
>surgeon and get him to fix the enterocoele or will it come right? Or
>would a referral to a Gynacologist be better in this situation? A health
>nurse told me to find out about a Sacropexy to fix it. If I can't cope
>will ask for a ileostomy bag to bypass the bowel emptying problem.
>
>Thank you
>
>--
>Veronica
>
--
Harvey S. Marchbein, M.D. FACOG, FACS
Great Neck, New York
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