I have already been diagnosed with a cysto-urethrocele ( thought to be mild but I was too scared to push much on examination plus bowel empty so the bulge didnt come like it had before) I have pain passing water after bowel movement ( I was negative for UTI) plus pain and bloating low down in abdomen, inside pelvis, groin and back and constipation which I now take medicaiton for. Urine retention around bowel movements etc., A pushing down feeling in vagina when upright.
My doctor is sending me to a urogynae but the referal has not been sent yet and could take time due to backlog of work at surgery.
I had an ultrasound interenally and externally this morning which proved inconclusive plus my ovaries could not be found. The ultrasound operator told me i have some fibroids but felt they were not bad at all and said that they would not be able to look at the small bowel or large bowel as ultrasound is not the best way to look at the bowel.
I have heard that even urogynacologists dont always know there is an enterocele until the patient is opened up.
Can you please tell me how an enterocele is detected and what tests help to find out if there is one present?
I would agree with your doctor that you should see an Urogynecologyist and be evaluated. A bulge in the posterior (bottom) vaginal wall can be from the rectum (rectocele), small intestines (entrocele) or both. Diagnosis is most often made by pelvic examination, which includes rectal exam as well as vaginal exam. You are correct in stating that examination as compared to surgical findings is correct in approximately 60% of cases. This however is not of great concern because both rectocele and enterocele can be repaired at the time of surgery. Most patients will have more than one defect.
As far as confirmatory testing, Defecography (a radiology study done with contrast material) and Dynamic MRI (a special Magnetic Resonance Imaging technique) can be used to differentiate between a rectocele, enterocele, and other pelvic floor disorders (fallen bladder, etc.) These are highly specialized test often not available in smaller medical centers.
Hopefully you will be able to be seen soon. Thank you for your question. J. Kyle Mathews, MD
Thank you for your answer. It was helpful. I hope to find out what is wrong before I am operated on so I can look at my choices. Am unable to stand or stay upright for too long at present due to pressure on my bladder from bowel ( I am slim though ) .
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