Coitus induced vaginal evisceration in a premenopausal woman: a case report

Nishikant N Gujar,Mahendra B Bendre,Geeta R Choudhari,Nasheen M Bagali,Ravikumar K Choudhari,Santosh B Adgale

doi:10.1186/1754-9493-5-6

Nishikant N Gujar, Mahendra B Bendre + Show 4 more

Open Access

https://doi.org/10.1186/1754-9493-5-6

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Abstract

Vaginal evisceration in premenopausal women after trans-abdominal hysterectomy is extremely rare in occurrence and only few cases have been documented in worldwide literature. Here we report a premenopausal woman with coitus induced trans-vaginal evisceration who had undergone trans-abdominal hysterectomy two years ago.This article highlights coitus as a trigger event for inducing vaginal evisceration and that vaginal evisceration caused by sexual intercourse should be considered in the field of surgery when a pre-menopausal woman presents with acute abdominal pain with no history of any other traumatic episode.

Highlights

Hysterectomy is an extremely common procedure performed routinely on a global basis with recognized complications which include infection, bleeding, bladder injury and prolapse of the vaginal vault [1].Vaginal evisceration after transabdominal hysterectomy in a pre-menopausal patient with vault rupture and prolapse of small bowel during sexual intercourse is an extremely rare event, and when it occurs, it is a surgical emergency [2,3].Since the first report in 1864 by Hyernaux, 113 cases have been reported in medical literature [4]
We report a case of coitus-induced vaginal evisceration in a pre-menopausal female patient, with prolapse of around 1 meter of small bowel through the vagina; who had undergone abdominal hysterectomy two years back for dysfunctional uterine bleeding (DUB)
The incidence of vaginal rupture after any type of pelvic surgery is 0.03 percent with the reported incidence of cuff dehiscence after a hysterectomy being higher after laparoscopic hysterectomy compared with abdominal or vaginal hysterectomies [5,6]

Summary

Background

Hysterectomy is an extremely common procedure performed routinely on a global basis with recognized complications which include infection, bleeding, bladder injury and prolapse of the vaginal vault [1]. Vaginal evisceration after transabdominal hysterectomy in a pre-menopausal patient with vault rupture and prolapse of small bowel during sexual intercourse is an extremely rare event, and when it occurs, it is a surgical emergency [2,3]. We report a case of coitus-induced vaginal evisceration in a pre-menopausal female patient, with prolapse of around 1 meter of small bowel through the vagina; who had undergone abdominal hysterectomy two years back for dysfunctional uterine bleeding (DUB). The pain had become progressively worse, was constant in nature and accompanied by nausea Her last sexual intercourse had been 4 days earlier, at which time she had experienced lower abdominal discomfort and slight vaginal bleeding. She recovered uneventfully and was discharged on 7th post operative day

Discussion

Conclusion