[The problem of enterocele (author's transl)]

During the past nine years 70 enteroceles were observed. There were 27 primary and 43 secondary enteroceles. Etiologic factors were multiparity, advanced age, general lack of elasticity, obestiy, constipation and increased intra-abdominal pressure. The pathogenesis of primary enteroceles was usually to do a genital prolapse, tissue atrophy, a distended pouch of Douglas due to a tumour. The pathogenesis of secondary enterocele following previous uterine surgery was that at times the pre-existent enterocele had not been observed and the space between the uterosacral ligament and the rectum not been closed, or the patients had vaginal hysterectomies and anterior and posterior colporrhaphies, or the patients had previous uterine suspensions or abdominal hysterectomies. The interval between uterine surgery and enterocele was a mean 1.5 years for vaginal hysterectomies and a mean 15 years for the other operations. Different operative procedures for enterocele are discussed. In 90% of the cases the enteroceles were repaired vaginally by the method of Shaw O'Sullivan.