Vaginal Cuff Dehiscence (VCD) is partial or total separation of anterior and posterior vaginal cuff layers. We report a case of recurrent vault cuff dehiscence in a patient of cervical carcinoma. A 60-year-old treated case of carcinoma cervix post surgery and radiotherapy was found to have vault dehiscence and intestinal prolapse second time during a routine speculum examination. She underwent an emergency laparotomy and closure of vault. Vaginal Cuff Dehiscence with Evisceration (VCDE) is a rare but potentially fatal complication following hysterectomy. Postoperative infection, poor technique, hematoma, coitus before healing, radiotherapy, corticosteroid therapy are the risk factors. Radiotherapy leads to progressive obliterative endarteritis and resultant tissue hypoxia. There is paucity of literature regarding the best management of VCD, but early corrective intervention is necessary. Patients and the treating physicians should be made aware of this possibility especially those receiving adjuvant radiation or cases of robotic or laparoscopic hysterectomies.
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http://dx.doi.org/10.7860/JCDR/2017/28389.10508 | DOI Listing |
JSLS
January 2025
Department of Obstetrics, Gynecology and Reproductive Biology, Danbury Hospital, Danbury, CT. (Drs. Brzozowski, Laibangyang, Gill, Talari, Nolan, Wakefield, Doo, and Chuang).
Background: Proficiency with laparoscopic suturing is often the rate-limiting step in performing a total laparoscopic hysterectomy. Intracorporeal suturing is challenging due to difficulties with needle control and tissue handling. Endoscopic suturing devices may improve operator experience.
View Article and Find Full Text PDFBMC Surg
January 2025
Department of Obstetrics and Gynaecology, Krankenhaus Sachsenhausen, Frankfurt Am Main, Germany.
Background: Total laparoscopic hysterectomy (TLH) is nowadays the standard to treat benign and malignant disease occurring in the uterus, but the number of robotic-assisted surgeries is increasing worldwide. To facilitate the handling of sutures in a bi- and tri-dimensional plane, a new type of suture material has been developed, named barbed sutures, which are in use in different indications. In comparison to conventional suture materials, the barbs anchor the suture in the tissue, provide tissue approximation and prevent slippage without the need for knot tying.
View Article and Find Full Text PDFTaiwan J Obstet Gynecol
January 2025
Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung 40203, Taiwan; Institute of Medicine, Chung Shan Medical University, Taichung 40203, Taiwan.
Objective: This case report aims to present a rare occurrence of fallopian tube prolapse into the vaginal vault following hysterectomy, underscoring the importance of recognizing this uncommon complication.
Case Report: A 45-year-old woman, with a history of hysterectomy for adenomyosis, presented with symptoms mimicking a vaginal tumor, including persistent discharge, abdominal pain, postcoital bleeding, and weight loss. Imaging raised concerns of malignancy, but surgery revealed a prolapsed fallopian tube with chronic inflammation.
J Clin Med
December 2024
Scientific and Innovative Program Med for Health, Medical University Pleven, 1, Saint Kliment Ohridski Street, 5800 Pleven, Bulgaria.
: The objective of this study is to prospectively collect dosimetric and clinical data on vaginal cuff electronic brachytherapy and propose a protocol for the procedure. Twenty-five patients who had proven endometrial or cervical carcinoma and had undergone radical hysterectomy have been treated with vaginal cuff electronic brachytherapy. Treatment session durations and doses to the targets and the organs at risk have been extracted from the treatment planning software.
View Article and Find Full Text PDFCase Rep Womens Health
December 2024
Department of General Gynecology and Gynecologic Oncology, Medical University of Vienna, Austria.
Anterior exenteration is a radical surgical option for treating locally advanced pelvic malignancies when alternative treatments are deemed ineffective or inappropriate. Due to its nature as an ablative treatment, interference with supportive structures of the pelvic floor can result in pelvic organ prolapse. A 70-year-old woman presented with prolapse after radical cystectomy and following two unsuccessful attempts at Le Fort colpocleisis, the second of which was further complicated by rupture of the vaginal cuff.
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