Third Grade Uterine Prolapse in Young Age after Second Surgical Reconstruction

Abstract

Recurrent Pelvic organ prolapse is a condition that affects the quality of life for women. Uterine prolapse percentage reached 35-50 % of women and the incidence increases with age and parity. In young women in reproductive age, uterine prolapse incidence is low, only 2 % nulliparous women experience POP. This case report aims to study the causes of uterine prolapse stage III-IV at young age after second reconstructive surgery. A 38 years old woman came to gynecology outpatient clinic dr Soetomo hospital, her chief complaint was uterine dropped after second reconstructive surgery. She had the first surgery at the age of 22, with reduction of round ligament (Baldy-Webster suspension), and had the second reconstruction surgery at the age of 31 years. A Purandare procedure was done few weeks afterwards, when she had cough and the pelvic organ going downward again. The third operation is scheduled, few weeks afterward, it was decided to do purandare procedure because of her age and nulliparity. However, due to severe adhesion and during surgery right tuboovarial abcess is found, SVH-SOD, adhesiolisis and Purandare procedure to suspend cervix stomp. Histopathologic result shows decreased collagen levels IA2. As a conclusion, the cause of twice uterine prolapse in these patients is the decrease of collagen, intraabdominal pressure and infection from tuboovarial abscess.