Diseases and Conditions

Small bowel prolapse (enterocele)

Treatment

Small bowel prolapse typically doesn't need treatment if the symptoms don't trouble you. Surgery may be effective if you have advanced prolapse with bothersome symptoms. Nonsurgical approaches are available if you wish to avoid surgery, if surgery would be too risky or if you want to become pregnant in the future.

Treatment options for small bowel prolapse include:

  • Observation. If your prolapse causes few or no obvious symptoms, you don't need treatment. Simple self-care measures, such as performing exercises called Kegel exercises to strengthen your pelvic muscles, may provide symptom relief. Avoiding heavy lifting and constipation may reduce the likelihood of worsening your prolapse.
  • Pessary. A silicone, plastic or rubber device inserted into your vagina supports the bulging tissue. Pessaries come in a variety of styles and sizes. Finding the right one involves some trial and error. Your doctor measures and fits you for the device, and you learn how to insert, remove and clean it.
  • Surgery. A surgeon can perform surgery to repair the prolapse through the vagina or abdomen, with or without robotic assistance. During the procedure, your surgeon moves the prolapsed small bowel back into place and tightens the connective tissue of your pelvic floor. Sometimes, small portions of synthetic mesh may be used to help support weakened tissues.

    A small bowel prolapse usually doesn't recur. However, further injury to the pelvic floor can happen with increased pelvic pressure, for instance with constipation, coughing, obesity or heavy lifting.