Transvaginal Peritoneocele Repair with Anterior Levatorplasty in Patients with a Rectocele and an Enterocele

Kotaro Maeda1*, Yoshikazu Koide2, Hidetoshi Katsuno3, Tsunekazu Hanai2, Koji Masumori2, Hiroshi Matsuoka2, Tomoyoshi Endo3 and Yeong Cheol Cheong2

1Department of Surgery, International Medical Center, Fujita Health University Hospital, Japan
2Department of Surgery, Fujita Health University School of Medicine, Japan
3Department of Surgery, Fujita Health University Okazaki Medical Center, Japan

^*Correspondance to: Kotaro Maeda 

 PDF  Full Text DOI: 10.25107/2474-1647.2883

Abstract

Enterocele is defined as a herniation of the peritoneal sac between the vagina and the rectum. Its predisposing conditions include a peritoneocele or a deep peritoneal sac which induce a rectal prolapse and the enterocele. Enteroceles and rectoceles often contribute to the symptoms of vaginal mass and pelvic discomfort. The combination of a rectocele and an enterocele as pelvic organ prolapses is not infrequent. However, the literature data on possible simultaneous treatments of those two conditions is scarce. We herein report a new and simple procedure for repairing the enterocele during a transvaginal anterior levatorplasty with posterior colporrhaphy for the rectocele repair. The technique includes performing an excision of the peritoneal sac with high ligation and attaching the uterine cervix and/or cardinal ligament to the upper most part of the approximation of the levator muscles in order to reinforce and lift the deep peritoneal sac. Hence, this procedure allows for a transvaginal repair of both enterocele and rectocele. The visualization of an enterocele is facilitated by pasting the barium to the posterior vaginal wall during defecography.

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Cite the article

Maeda K, Koide Y, Katsuno H, Hanai T, Masumori K, Matsuoka H, et al. Transvaginal Peritoneocele Repair with Anterior Levatorplasty in Patients with a Rectocele and an Enterocele. Clin Surg. 2020; 5: 2883..