Pelvic Organ Prolapse (POP) Expert Forum
Enterocele over bladder side plus cystocele?
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Enterocele over bladder side plus cystocele?

So far in the UK I have seen 2 Urogynaecologists.  One has told me I have mild cystocele/urethrocele and recommended seeing gastro doctor for bowel and have bladder tests.  The other has told me I have rectocele and recommended I see bowel doctor and have bladder tests.

I have long term constipation now treated, pains in lower abdomen and back like period pain and pain and pressure on bladder/loss of some sensation with other pain also in upper legs and groin and bloating in lower abdomen. Pains get better when lying down.   A hard lump appeared in vagina on bladder side after a lot of straining and there is a soft lump on rectal side which flutuates.  

I accept that I have rectocele and wonder if the hard lump from bladder side may stay away now that I am not straining to pass bowel movements?  I am doing kegels.

What is very worrying to me is that both Urogynaecologists said that pains in abdomen and back and pressure on bladder was not due to prolapse as they are not prolapse symptoms and when I asked if they could be due to an enterocele on bladder side ( anterior entercele I think it is called ) I was told that this is impossible and that enteroceles only occur at the back on the rectum side and never on top of bladder or on that side at all.  

Can you tell me if enteroceles can occur on the bladder side and if a colorectol surgeon will be able to detect any possibility of enterocele or if only gastrointerologists can detect them.

I am very worried as I have seen very good Urogynaecologists in my country and expected them to be able to understand all aspects of prolapse.  My goal is to find out the facts of my condition/s and then consider my options but am presently unsure as to what to do to achieve this.

Any ideas would be very grateful, thank you.

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Anterior wall ( bladder side) Enteroceles do occur in women with history of Hysterectomy.  While a colorectal surgeon may repair an anterior enterocele, you might be better served by a Urogynecologist that can repair all the defects present.  A Gastroenterologist would not perform surgery and the presence of defects should be visible to all three doctors, gastroenterologist , colorectal surgeon, & urogyn.  If there is disagreement on what defects are present. Radiological studies, deftography, or dynamic MRI may be done.  Symptoms from pelvic organ prolapse may include a wide variety of complaints.  I would suggest you seek a second opinion if possible.  Thank you for your question. J. Kyle Mathews, MD
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J. Kyle Mathews, MD, DVMBlank
Plano Urogynecology Associates
Plano, TX
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