The Clinical Features of Enterocoele
There has been much confusion with enterocoele nomenclature in the past ever since first descriptions by de Garengeot (1743) and Astley Cooper (1804). Gaillard Thomas (1885) presented a comprehensive classification of hernias appearing in the vagina or vulva and included “vaginal enterocoele or hernia, meaning the descent of a small portion of small intestine into the vagina”. Pudendal or perineal enterocoele similarly was applied to small bowel descent into the labium majus or perineum and these two groups were further subdivided depending upon the contents of the sac. Vaginal hernia, declared by Sweetser (1919) to be a great rarity, found an exit either anterior or posterior to the broad ligament, the anterior hernia descending between the broad ligament and bladder to push the anterior vaginal wall forward, whilst the posterior perforated part of the levator muscle pushing forward the posterior vaginal wall. Miles (1926) suggested pelvic hernia as an inclusive term for all herniae passing through the pelvic floor, and subvarieties were named by their point of egress to be consistent with best usage in hernia nomenclature. Miles subdivisions were pudendal, perineal and vaginal; the latter being split further into anterior or posterior, depending upon the relationship of the sac to the uterus with the anterior vaginal hernia following the cleavage plane between bladder and anterior vaginal wall.
KeywordsPelvic Floor Vaginal Wall Rectal Prolapse Vaginal Hysterectomy Anterior Vaginal Wall
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