Abstract

Hysterectomy is the most common gynecological major surgery. It is performed for both benign and malignant conditions of the female genital tract. Common indications of hysterectomy include abnormal uterine bleeding (fibroids, adenomyosis), pelvic inflammatory disease. It can be performed via abdominal or vaginal routes depending on the pathology. In this era of minimally invasive surgery, laparoscopic hysterectomy is gaining popularity. Complications of this surgery depend on the etiology, route of hysterectomy and the technique used. Common complications of this procedure include infections, hemorrhage, thromboembolism, urinary tract, gastrointestinal injury. Vault prolapse can also occur years after performing a hysterectomy. Prolapse of fallopian tubes and omentum through the vault have been reported. However, prolapse of other abdominal and pelvic organs like bowel, ovary, and bladder through the vaginal vault is a rare entity. Prolapse of the ovarian cyst through vaginal vault has so far not been reported in the world literature. The present case report was of a very rare case of ovarian cyst prolapse through the vaginal vault in a 35-year-old woman; which was successfully treated by laparotomy and ovarian cystectomy. Her post-operative histopathology was suggestive of mucinous cystadenoma. Her post-operative period was uneventful, and she was discharged in a stable condition.

Highlights

  • Hysterectomy is the most common surgery performed in Gynecology

  • The present case report was of a rare case of ovarian cyst prolapse through the vaginal vault ten years after hysterectomy

  • Fig-1: MRI – Contrast-enhanced showed Huge complex cystic mass – 10.9 cm x 8.3 cm x 9.1 cm in the pelvis prolapsing through the cervical stump (Ovarian cyst prolapsing through cervical stumpor), through the vaginal vault).A cyst of size 4 cm noted in the left ovary appearing to be a benign lesion

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Summary

Introduction

Hysterectomy is the most common surgery performed in Gynecology. It is performed for both benign and malignant conditions. The present case report was of a rare case of ovarian cyst prolapse through the vaginal vault ten years after hysterectomy. P/S: Irregular mass of size 4x3 cm seen prolapsing through the right side of the vault. Right ovarian mass found to be extending through the vault into the vagina and adherent to the posterior vaginal wall which is separated and removed. Fig-1: MRI – Contrast-enhanced showed Huge complex cystic mass – 10.9 cm x 8.3 cm x 9.1 cm in the pelvis prolapsing through the cervical stump (Ovarian cyst prolapsing through cervical stumpor), through the vaginal vault).A cyst of size 4 cm noted in the left ovary appearing to be a benign lesion. Operative procedure: A cystic mass of 10x4cms in right iliac fossa retroperitoneally seen. Ureter identified and separated from the mass at its lower 1/3rd

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Conclusion

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