Transvaginal peritoneocele repair with anterior levatorplasty for patients with a rectocele and an enterocele

Surg Today. 2021 May;51(5):844-847. doi: 10.1007/s00595-020-02161-w. Epub 2020 Oct 8.


Enteroceles and rectoceles are often identified as the cause of a vaginal mass and pelvic discomfort. The combination of a rectocele and an enterocele as pelvic organ prolapses is not infrequent; however, there are few reports on possible simultaneous treatments of these two conditions. We report a new and simple procedure for repairing an enterocele during a transvaginal anterior levatorplasty with posterior colporrhaphy for a rectocele repair. This technique involves making an excision in 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, to reinforce and lift the deep peritoneal sac. This procedure allows for transvaginal repair of both an enterocele and a rectocele. The enterocele is visualized by applying barium to the posterior vaginal wall during defecography.

Keywords: Enterocele repair; Rectocele; Transvaginal anterior levatorplasty.

MeSH terms

  • Barium
  • Defecography
  • Female
  • Gynecologic Surgical Procedures / methods*
  • Hernia / complications*
  • Hernia / diagnostic imaging
  • Herniorrhaphy / methods*
  • Humans
  • Pelvic Organ Prolapse / etiology
  • Pelvic Organ Prolapse / surgery
  • Rectocele / complications*
  • Rectocele / surgery*
  • Vagina / surgery


  • Barium