Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with a sensation of pelvic pressure, vaginal fullness, and a dragging sensation in the lower abdomen, exacerbated by standing or straining. Symptoms are relieved by recumbency. Denies acute bowel obstruction symptoms, fever, or hematochezia. History of pelvic floor dysfunction or prior pelvic surgery noted.
Clinical Examination Findings
Pelvic examination reveals a soft, reducible mass in the posterior vaginal fornix, which becomes more prominent during Valsalva maneuver. Digital rectal examination confirms the presence of bowel loops within the rectovaginal septum. No signs of incarceration, strangulation, or mucosal ulceration noted.
Treatment Protocol
Conservative management includes pelvic floor physical therapy and lifestyle modifications (avoiding heavy lifting, straining). Surgical intervention (enterocele repair/colporrhaphy) is indicated for symptomatic, progressive, or incarcerated cases. Mesh-augmented repair or native tissue repair options discussed based on patient risk profile.