Skip to main content

Advertisement

Log in

Anterior enterocele as an etiology for anterior vaginal wall prolapse: a magnetic resonance defecography case series

  • Special Section: The pelvic floor
  • Published:
Abdominal Radiology Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. 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

  2. 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

    CAS  PubMed  Google Scholar 

  3. 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

    Article  CAS  PubMed  Google Scholar 

  4. 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

    Article  PubMed  Google Scholar 

  5. 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

    Article  CAS  Google Scholar 

  6. 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

    Article  PubMed  Google Scholar 

  7. 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

    Article  CAS  Google Scholar 

  8. 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

    Article  PubMed  PubMed Central  Google Scholar 

  9. 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

    Article  PubMed  Google Scholar 

Download references

Funding

None

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Gaurav Khatri.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

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

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00261-019-02327-2

Keywords

Navigation