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Diagnosis of Posterior Enterocele

Comparison of Rectal Ultrasonography With Intraoperative Diagnosis

Department of Gynecology, Academic Hospital Rotterdam Dijkzigt, Rotterdam, the Netherlands.

Address correspondence and reprint requests to Mark E. Vierhout, Department of Gynecology, Aca-demic Hospital Rotterdam Dijkzigt, PO Box 2040, 3000 CA Rotterdam, the Netherlands.

Objective. To describe a new ultrasonographic technique and to compare it with intraoperative findings in women with a suspected enterocele. Methods. An observational study was conducted in the Department of Gynecology of a medium-sized teaching hospital. Twenty-nine patients with clinical and ultrasonographic diagnoses of an enterocele were reviewed. All patients had vaginal repair surgery, including a posterior repair in which the existence of an enterocele was confirmed or denied. Results. In 27 of the 29 patients, the enterocele was diagnosed as such during surgery and handled accordingly. The 2 enteroceles that were not confirmed were smaller types. Conclusions. Rectal ultrasonographic findings were in good accordance with intraoperative anatomic characteristics. Rectal ultrasonography has the capability of diagnosing small, occult enteroceles. This can have important clinical implications in the prophylactic use of additional enterocele repair during hysterectomy or prolapse surgery.

Key Words: enterocele • gynecologic ultrasonography • hysterectomy • rectal ultrasonography