Diagnosis and Management of an Unusual Cyst 3 Years After Sacrocolpopexy.

Background: Peritoneal inclusion cysts (PICs) are uncommon tumours that can pose diagnostic challenges. This report describes an unusual etiology and management of recurrent pelvic organ prolapse.

Case: A 48-year-old premenopausal woman presented with recurrent prolapse and urinary frequency after total abdominal hysterectomy and synthetic mesh sacrocolpopexy. On examination, a stage II rectoenterocele was noted. Her post-void residual was 760 mL as measured by bladder scanner, discrepant with in-and-out catheterization. Pelvic ultrasound revealed a 19-cm cystic pelvic mass. At laparoscopy a PIC was identified, and cystectomy, uterosacral plication, and Moschcowitz culdoplasty were performed. Complete symptom resolution was documented at 4 weeks and 3 months postoperatively.

Conclusion: PICs should be included in the differential diagnosis of recurrent prolapse. Prolapse symptoms attributable to PICs can be treated with laparoscopic cystectomy.