Enterocele Repair Using Vaginal Tape: Sechenov University’s Approach
Sechenov University Urology Clinic has embraced a distinctive vaginal tape technique to treat enterocele that develops after hysterectomy. The approach places a polypropylene tape through the vagina to replace weakened ligaments and fascia, creating a new support strut for the vaginal walls and pelvic organs. By avoiding an abdominal dissection, this method lowers perioperative risk, shortens hospitalization, and speeds recovery while preserving native anatomy. The design is straightforward, reliable, and compatible with routine practice in high‑volume centers and regional clinics. In suitable patients this technique can be performed with minimal anesthesia requirements and without entering the abdominal cavity. The move toward vaginal tape repair reflects a shift toward less invasive, tissue‑friendly solutions that still deliver durable support. Clinicians point to safer, patient‑centered options that maintain function and comfort. The urology team at Sechenov University notes these outcomes from their experience.
Enterocele is a form of urogenital prolapse where the vaginal walls bulge with loops of small intestine. Unlike the classic prolapse after hysterectomy, enterocele centers on the small bowel. Patients may feel a bulge, pressure, and discomfort during activities that raise abdominal pressure, and symptoms vary from mild to significant. Because this condition involves the small intestine, it has different implications for surgery and long‑term pelvic floor stability compared with other prolapse types. In North American practice this condition is recognized as part of the spectrum of pelvic organ prolapse that requires individualized planning.
Dr. Mikhail Enikeev, head of the urology department at Sechenov University, explains that after prolapse severe enough to require hysterectomy, the uterus is often removed along with the cervix. This reduces vaginal suturing options and alters pelvic fascia and ligamentous support, which can create space for bowel loops to descend. When the uterus and its supporting structures are detached, the pelvic floor loses part of its natural support, and the small intestine may progressively contribute to a late prolapse. The result is enterocele with the bladder and bowel loops part of the hernia, and a lifetime risk of recurrence remains a consideration even after initial repair.
Traditional enterocele repair often uses an abdominal approach in which the vaginal dome is mobilized and anchored to the sacrum, creating a fixed, bone‑like support. This procedure is technically demanding, lengthy, and demanding in terms of recovery. The newer vaginal tape method replaces weakened pelvic ligaments and fascia with a polypropylene strip inserted through the vaginal route. The tape is sutured to residual pelvic fascia with nonabsorbable sutures, and its ends are pulled upward to restore the proper support for the vaginal walls and pelvic organs. In cases where the fascia is almost completely deficient, a small graft of polypropylene material measuring 6 by 8 centimeters may be used to provide a stable foundation. The claimed advantages include simpler construction, reliable performance, and a safer profile. In many instances the technique can be performed without general anesthesia and without entering the abdominal cavity. This approach offers a practical option for patients who need durable repair while reducing surgical burden.
Clinicians in Canada and the United States observe this development with interest as doctors seek to balance durable results with patient safety. The vaginal tape approach aligns with broader moves toward minimally invasive prolapse repair that preserves anatomy and function. As with any pelvic floor operation, patient selection, anatomical assessment, and informed consent are essential, and surgeons emphasize careful postoperative follow up to monitor for recurrence. The Sechenov experience shows that even after hysterectomy, less invasive vaginal techniques can achieve solid correction of enterocele while keeping recovery time short and hospital stays modest.