Pelvic organ prolapse and uterine inversion: A case report and literature review

Abstract Background Iatrogenic endometriosis is the presence of endometrial glands and stroma out of the uterus following certain surgical interventions. The rate of iatrogenic endometriosis after gynecologic surgeries due to benign uterine disease is 1–2%. Laparoscopic supracervical hysterectomy is also a part of frequently used surgical treatment of apical pelvic organ prolapse, which is followed by sacrocervicopexy. However, there are no data about iatrogenic endometriosis after apical prolapse surgery in the current literature. Herein, we present a case report of a patient diagnosed with de novo endometriosis 1 year after laparoscopic supracervical hysterectomy and sacrocervicopexy. Case presentation A 46-year-old parous Slavic woman who underwent laparoscopic supracervical hysterectomy and sacrocervicopexy secondary to grade 3 symptomatic apical prolapse 1 year earlier was admitted to the same clinic with pelvic pain that had started 6 months following surgery. Deep vaginal palpation was painful. Transvaginal ultrasonography revealed an area with hypervascularization on the sacral promontory. She was scheduled for diagnostic laparoscopy. A 2 × 2-cm solid, wine-colored, hypervascular hemorrhagic lesion was seen on the sacral promontory. The lesion and the peritoneal layer behind it were totally excised. The patient was discharged on the first postoperative day, without any complications. Pathologic examination revealed foci of endometriosis comprising endometrial glands and stroma within the connective tissue, along with hemosiderin-laden macrophages. The symptoms of the patient resolved after the surgery, and no further adjuvant treatment was needed. Conclusion Although the rate of iatrogenic endometriosis is low after laparoscopic supracervical hysterectomy and sacrocervicopexy, the possibility of the occurrence of iatrogenic endometriosis should be discussed with patients who are diagnosed with apical prolapse to determine the type of surgical intervention. Iatrogenic endometriosis should be kept in mind for differential diagnosis in case of pain after laparoscopic supracervical hysterectomy and sacrocervicopexy.

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Nonpuerperal uterine inversion due to adenomyosis: A case report and a literature review

Clinical Case Reports ◽

10.1002/ccr3.2530 ◽

2019 ◽

Vol 7 (12) ◽

pp. 2420-2424

Author(s):

Philippe Merviel ◽

Sandrine Guilbert ◽

Coline Abou Hassan ◽

Isabelle Thomas‐Kergastel ◽

Virginie Conan‐Charlet ◽

...

Keyword(s):

Case Report ◽

Literature Review ◽

Uterine Inversion

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“Locus minoris resistentiae” and connective tissue weakness in older women: a case report and literature review on pelvic organ prolapse with inguinal bladder hernia

BMC Women s Health ◽

10.1186/s12905-021-01554-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

A. Esber ◽

A. Kopera ◽

M. P. Radosa ◽

I. B. Runnebaum ◽

H. K. Mothes ◽

...

Keyword(s):

Case Report ◽

Inguinal Hernia ◽

Pelvic Organ Prolapse ◽

Connective Tissue ◽

Genital Prolapse ◽

Pelvic Organ ◽

Simultaneous Occurrence ◽

Patient Counselling ◽

Hernia Sac ◽

Bladder Hernia

Abstract Background Conditions such as genital prolapse and hernia are known to be related to connective tissue dysfunction. In this report on cases of the rare simultaneous finding of large genital prolapse and post-prolapse repair female inguinal bladder hernia, we aim to contribute to the discussion of a possible clinical definition of connective tissue weakness, for its clinical assessment and preoperative patient counselling. Case presentation Three cases of medial third-grade (MIII, Aachen classification) inguinal bladder hernia developing or enlarging after successful stage-IV pelvic organ prolapse (POP) repair at a university pelvic floor centre are presented. All patients were aged ≥ 80 years with long-standing postmenopausal status. One patient was followed for 5 years and two patients were followed for 6 months. In all patients, ultrasound revealed that the hernia sac contained the urinary bladder, which had herniated through the inguinal hernia orifice. A literature search revealed only one case report of direct female inguinal bladder hernia and few investigations of the simultaneous occurrence of POP and hernia in general. Conclusion The simultaneous occurrence of inguinal hernia and female POP can lead to bladder herniation following prolapse surgery in the sense of a “locus minoris resistentiae”. Clinical examination for simultaneous signs of connective tissue weakness and counselling prior to pelvic reconstructive surgery could help to increase patients’ compliance with further surgical treatment for hernia.

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A 27-Year-Old Patient with Congenital Bladder Exstrophy and Recurrent Pelvic Organ Prolapse: a Case Report

Acta Clinica Croatica ◽

10.20471/acc.2020.59.02.24 ◽

2020 ◽

Author(s):

Vladimir Banović

Keyword(s):

Case Report ◽

Pelvic Organ Prolapse ◽

Bladder Exstrophy ◽

Pelvic Organ ◽

Recurrent Pelvic Organ Prolapse

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Uterovaginal prolapse following suspected sexual abuse to a child: a case report

Annals of Pediatric Surgery ◽

10.1186/s43159-021-00105-8 ◽

2021 ◽

Vol 17 (1) ◽

Author(s):

Odion-Obomhense Kesiena Helen ◽

Ntaji Maureen Iru ◽

Ekpebe Patrick Akpofure ◽

Afeyodion Akhator

Keyword(s):

Sexual Abuse ◽

Case Report ◽

Pelvic Organ Prolapse ◽

Pelvic Organ ◽

Uterovaginal Prolapse ◽

Traumatic Rupture ◽

Connective Tissues ◽

Case Presentation ◽

History Of

Abstract Background Uterovaginal prolapse occurs when damaged connective tissues allow the uterus to drop into the vagina. Rare in children, uterovaginal prolapse can occur as a result of violent sexual assault. This case is being reported because there has been no previous report of acquired pelvic organ prolapse following trauma suspected to be sexual abuse in a child in our setting. Case presentation Two-year-old female presented to our hospital with a 3-day history of abnormal protrusion from the vagina and a 2-day history of bleeding per vagina. Traumatic rupture of the hymen was observed. The urethra was not edematous or hyperemic. The reduction was done successfully under sedation and maintained using a crepe bandage. There was no recurrence after 3-month follow-up. Conclusions Uterovaginal prolapse presenting among children below 5 years is rare. If bleeding per vagina is reported in a child, the clinician should be aware of the possibility of uterovaginal prolapse.

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Urinary Retention Secondary to Colpocleisis: A Case Report

Open Medicine Journal ◽

10.2174/1874220302108010008 ◽

2021 ◽

Vol 8 (1) ◽

pp. 8-11

Author(s):

Elena Soto-Vega ◽

Yunam Cuan-Baltazar ◽

Arturo García-Mora ◽

Carlos Arroyo

Keyword(s):

Adverse Event ◽

Case Report ◽

Pelvic Organ Prolapse ◽

Older Women ◽

Urinary Retention ◽

Clinical Case ◽

Pelvic Organ ◽

Urethral Meatus ◽

Vaginal Canal

Introduction: Pelvic Organ Prolapse (POP) is common in older women, and depending on its extent, it is conservative or surgically treated. Colpocleisis is a technique for POP treatment, in which the vaginal canal is closed, entirely or partially, in order to avoid the protrusion of the pelvic structures, with preservation of the urethral meatus in order to preserve normal micturition. Clinical Case: We present a case of a 61-year old woman, who 8 years after a colpocleisis, progressed to urinary retention associated with the progressive scarring of the labia, causing the obstruction of the urethral meatus. The patient underwent a labiaplasty with anterior colpoperineoplasty, with complete normalization of her micturition and sexual activity. Conclusion: Long term urinary retention complication has not been previously reported in the literature and should be included as a possible adverse event after colpocleisis.

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Neglected Pessary in Patient with Pelvic Organ Prolapse: A Case Report

Journal of Family & Reproductive Health ◽

10.18502/jfrh.v13i3.2132 ◽

2019 ◽

Author(s):

Zinat Ghanbari ◽

Maryam Deldar-Pesikhani ◽

Tahereh Eftekhar ◽

Leila Pourali ◽

Atiyeh Vatanchi ◽

...

Keyword(s):

Case Report ◽

Pelvic Organ Prolapse ◽

Pelvic Floor ◽

Pelvic Organ ◽

Purulent Discharge ◽

Vaginal Mucosa ◽

Academic Hospital ◽

Vaginal Pessary ◽

First Choice

Objective: To report the neglected pessary in a patient with pelvic organ prolapse. Pelvic organ prolapse (POP) is one of the most important medical challenges in women especially elderly. One of the conservative treatments of symptomatic POP is pessary placement. Case report: A 84-year-old woman, para 10 was referred to female pelvic floor clinic of an academic hospital for vaginal bleeding and neglected vaginal pessary. Vaginal examination in the pelvic floor clinic revealed an entrapped ring pessary in severely atrophic vaginal mucosa with purulent discharge. Conclusion: Although pessary is the first choice and one of the best conservative treatment for pelvic organ prolapse, it shouldn’t be used for poor cooperative patient who cannot comply with regular follow-up visits which may cause harmful complications.

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