Abstract
BackgroundVaginal cuff dehiscence is a rare but potentially grave complication after total hysterectomy. Abdominal or pelvic contents are at risk of evisceration through the vaginal opening. It is associated with significant risk for patient morbidity, such as peritonitis, bowel injury, and sepsis.Case presentationWe report a case of vaginal cuff dehiscence in a 45-year-old multiparous Taiwanese woman who had undergone abdominal total hysterectomy and presented with vaginal cuff dehiscence precipitated by sexual intercourse. Immediate laparoscopic repair was done. Few authors have reported the utilization of the laparoscopic approach. It allows thorough inspection, visualization, and irrigation of the abdominal cavity. It is also associated with fewer intraoperative and postoperative complications.ConclusionLaparoscopic repair is a safe treatment option to manage vaginal cuff dehiscence after total hysterectomy.
Highlights
Vaginal cuff dehiscence (VCD) is a rare and distinct complication following pelvic surgery and has been reported with different modes of hysterectomy [1, 2]
Its incidence varies according to the mode of hysterectomy, surgical technique, suture utilized for cuff closure, and operator’s experience
We report a case of VCD in a multiparous woman who had undergone abdominal total hysterectomy and presented with VCD precipitated by sexual intercourse
Summary
Vaginal cuff dehiscence (VCD) is a rare and distinct complication following pelvic surgery and has been reported with different modes of hysterectomy [1, 2]. Introduction Vaginal cuff dehiscence (VCD) is a rare and distinct complication following pelvic surgery and has been reported with different modes of hysterectomy [1, 2]. An observational study reported the occurrence to be highest for laparoscopic hysterectomy compared with total vaginal and total abdominal approaches [1]. Post-hysterectomy VCD may present as early as 3 days to months or years after surgery with pelvic pain (60– 100%), vaginal bleeding (30–60%), vaginal discharge (30%), or vaginal pressure/mass (30%) [1, 5, 6].
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