Abstract
Pelvic floor hernias from the posterior cul-de-sac most often contain small bowel and are called enteroceles, however may contain sigmoid colon (sigmoidocele) or only peritoneal fat (peritoneocele). These cul-de-sac hernias typically cause bulging of the posterior vaginal wall, while anterior vaginal wall bulges are typically secondary to bladder prolapse in patients with pelvic floor deficiency. We report a series of seven patients who presented with anterior vaginal wall “mass” or bulge after cystectomy and were found on magnetic resonance defecography (MRD) to have enteroceles or sigmoidoceles in the anterior rather than posterior compartment. MRD was instrumental for diagnoses in these patients and to exclude local recurrence of bladder malignancy. We also report five additional patients that were found to have bowel herniation anterior to the vaginal apex, but without history of cystectomy.
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References
Boyadzhyan L, Raman SS, Raz S (2008) Role of static and dynamic MR imaging in surgical pelvic floor dysfunction. Radiographics : a review publication of the Radiological Society of North America, Inc 28 (4):949-967. https://doi.org/10.1148/rg.284075139
Li M, Jiang T, Peng P, Yang XQ, Wang WC (2015) Association of compartment defects in anorectal and pelvic floor dysfunction with female outlet obstruction constipation (OOC) by dynamic MR defecography. European review for medical and pharmacological sciences 19 (8):1407-1415
Bump RC, Mattiasson A, Bo K, Brubaker LP, DeLancey JO, Klarskov P, Shull BL, Smith AR (1996) The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. American journal of obstetrics and gynecology 175 (1):10-17. https://doi.org/10.1016/s0002-9378(96)70243-0
Khatri G, de Leon AD, Lockhart ME (2017) MR Imaging of the Pelvic Floor. Magnetic resonance imaging clinics of North America 25 (3):457-480. https://doi.org/10.1016/j.mric.2017.03.003
Hock D, Lombard R, Jehaes C, Markiewicz S, Penders L, Fontaine F, Cusumano G, Nelissen G (1993) Colpocystodefecography. Diseases of the colon and rectum 36 (11):1015-1021
Stav K, Dwyer PL, Rosamilia A, Lim YN, Alcalay M (2009) Transvaginal pelvic organ prolapse repair of anterior enterocele following cystectomy in females. International urogynecology journal and pelvic floor dysfunction 20 (4):411-415. https://doi.org/10.1007/s00192-008-0786-5
Anderson J, Carrion R, Ordorica R, Hoffman M, Arango H, Lockhart JL (1998) Anterior enterocele following cystectomy for intractable interstitial cystitis. The Journal of urology 159 (6):1868-1870
Wong KW, Lai TC, Ng AT, Ho BS, Tsu JH, Tsang CF, Ma WK, Yiu MK (2017) Anterior perineal hernia after anterior exenteration. Asian journal of urology 4 (4):253-255. https://doi.org/10.1016/j.ajur.2017.03.002
Honma I, Masumori N, Sato E, Takayanagi A, Takahashi A, Itoh N, Tamagawa M, Sato MA, Tsukamoto T (2004) Local recurrence after radical cystectomy for invasive bladder cancer: an analysis of predictive factors. Urology 64 (4):744-748. https://doi.org/10.1016/j.urology.2004.05.003
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Aziz, M., Khatri, G., Hess, D. et al. Anterior enterocele as an etiology for anterior vaginal wall prolapse: a magnetic resonance defecography case series. Abdom Radiol 46, 1390–1394 (2021). https://doi.org/10.1007/s00261-019-02327-2
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DOI: https://doi.org/10.1007/s00261-019-02327-2