Abstract
IntroductionGenitourinary tract trauma caused by ox horn injury in the presence of pelvic organ prolapse (POP) is an extremely rare phenomenon and associated with devastating morbidity.Case presentationA 50-year-old multiparous postmenopausal woman from rural northwest Ethiopia presented with the primary complaint of urinary incontinence 6 days after she suffered ox horn injury to her prolapsed genitalia. She had stage 3 pelvic organ prolapse with the leading point being the cervix. The anterior vaginal and posterior bladder walls were disrupted with visible draining of the left ureter. The wound was dirty and edematous with whitish discharge. She was admitted to the urogynecology ward and provided with wound care until the infection subsided. Apical prolapse suspension was performed using right sacrospinous fixation, and bladder repair was carried out 6 weeks following the prolapse suspension. She recovered well and was continent when discharged.ConclusionOx horn injury involving the female lower urogenital tract in the presence of POP is extremely rare. Late presentation after sustaining injury is associated with increased risk of morbidity and long hospital stay, and treatment requires multistage surgery.
Highlights
Genitourinary tract trauma caused by ox horn injury in the presence of pelvic organ prolapse (POP) is an extremely rare phenomenon and associated with devastating morbidity.Case presentation: A 50-year-old multiparous postmenopausal woman from rural northwest Ethiopia presented with the primary complaint of urinary incontinence 6 days after she suffered ox horn injury to her prolapsed genitalia
Urogenital tract trauma accounts for 10% of all abdominopelvic traumatic injuries of which bladder injury occurs in 1.6% of these cases [7, 8]
We present a case of bladder rupture in a postmenopausal woman with stage three pelvic organ prolapse (POP) that resulted from an injury caused by an ox horn
Summary
Ox horn injury involving the female genitourinary tract and resulting bladder rupture is extremely rare. The presence of advanced-stage POP increases the risk of severe complications. Late presentation will result in delayed repair and a longer hospital stay. Both the ureters were identified and stented prior to the repair. Vaginal packing and transurethral catheter were left in situ. The vaginal packing and the urinary catheter were removed after 24 hours and 3 weeks, respectively. The patient was fully continent when discharged on postoperative day 21 following bladder repair and on postoperative day 63 following her RSSF
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