Cases Of Prolapse Research Articles

REDISCOVERING RELIEF: A CASE REPORT ON EFFECTIVELY MANAGING SCIATICA WITH AYURVEDIC APPROACHES.

Gridhrasi is a common condition characterized by sequential pain that starts from the (buttock region) of Sphik Pradesh and radiates down to the foot. It can be correlated with Sciatica, radiating pain from the back to the lower limb with paraesthesia. The present case report is of a 43-year-old male patient, unable to walk due to se-vere back pain radiating to his left ankle. As per the previous MRI report, the patient had an established case of prolapse of the intervertebral disc (PIVD) with radiculopathy and took treatment at a private allopathic hospital, and they advised him to have surgery. The patient and his attendant refused surgery and came to our hospital. The patient was treated with Siravedha and oral medications. After improvement, the patient was maintained on back strengthening exercises. Visual Analogue Scale (VAS) score, comfortable walking distance, Straight Leg Raise (SLR) test, and % relief reported by the patient were used as assessment criteria. The patient was relieved from all symptoms with a follow-up period of 1 year. This case report shows that Siravedha and Ayurvedic oral management is very effective in Gridhrasi (PIVD with Radiculopathy). Hence, this treatment can be minimally cost-effective as a day-care procedure and protects the patient from surgical intervention.

Magnetic resonance defecography: Post-defecation straining detects more and maximal prolapse in the anterior and middle compartments

ObjectiveTo compare pre-defecation straining without rectal gel and post-defecation straining with the defecation phase, and to investigate their roles in evaluating pelvic organ prolapse (POP). Material & methodsMagnetic Resonance Defecography (MRD) images of 65 patients with a clinical diagnosis of POP were retrospectively reviewed by two independent readers. Measurements were taken at rest, pre-defecation straining without rectal gel, defecation, and post-defecation straining. The presence, sizes, and/or grades of cystocele, uterovaginal prolapse, widened levator hiatus, perineal descent, cul-de-sac hernia, rectocele, and rectal intussusception were evaluated and compared across the four phases. ResultsCompared to pre-defecation straining, both defecation and post-defecation straining detected more cases, larger sizes, and higher grades of prolapse in all compartments. When comparing defecation and post-defecation straining, the latter diagnosed four more cases of cystocele (80 % vs 73.9 %, p = 0.2) with larger size (−34.1 vs −29.0, p < 0.01) and higher grade (p = 0.19). Post-defecation straining also identified eight more cases of uterovaginal prolapse (89.2 % vs 73.9 %, p < 0.01) with larger size (−32.9 vs −26.4, p < 0.01) and higher grade (p < 0.01) compared to defecation. Conversely, defecation detected eight more cases of rectocele (46.2 % vs 33.9 %, p < 0.01) with larger size (9.2 vs 6.2 cm, p < 0.01) and higher grade (p = 0.26). ConclusionPost-defecation straining effectively depicts the maximal extent of prolapse in the anterior and middle compartments, and should be performed whenever there is a clinical need for a comprehensive assessment of prolapse in these compartments.

Efficacy of Dilapan S compared to foley balloon in preinduction cervical ripening—a noninferiority trial

The need for induction of labor is increasing in present obstetric practice. The available non-pharmacological methods for cervical ripening at term are Foley balloon and Dilapan-S. With the gaining popularity of Dilapan-S worldwide, there are very few clinical trials conducted in India to evaluate its effectiveness. To compare the efficacy of Dilapan-S and Foley balloons for pre-induction cervical ripening. This single-center randomized non-inferiority trial included primi- and multi-gravida women between 37 and 41 weeks of gestation and unfavourable cervix with a Bishop's score between 0 and 2. Using a random number table, patients were assigned to study Group 1 Dilapan-S and to control Group 2 Foley balloon. Dilapan-S or Foley balloon was inserted intracervically and assessed for dilation after 12 hours. Patients with unfavourable dilatation were further provided prostaglandins (PgE 1 and 2) for further augmentation of induction. Primary outcome measures included improvement in Bishop's score, and mode of delivery, followed by time to delivery from intervention, use of other augmentation methods, and maternal and neonatal outcomes. After screening, 296 patients with Bishop score less than 2, (148 in each group) were enrolled in the study. The number of patients who had vaginal delivery was comparable between both groups (p=.72), and so were the maternal outcomes. Two cases of cord prolapse occurred with Foley balloon. Group 2 showed significant improvement in Bishop's score (p<.001), and Group 1 had a significantly higher use of augmentation with PgE1 (p-.01) and PgE2 (p<.001). The number of contractions was significantly lower in Group 1 (p<.001), and contraction intensity was higher in Group 2. There was no significant difference in cesarean delivery for failed induction of labor between the groups (p=.72). Based on the primary outcome measure, Dilapan-S was found to be non-inferior to the Foley balloon. Dilapan-S is non-inferior to Foley balloon in achieving pre-induction cervical ripening in term pregnancies, and therefore Dilapan-S can be suggested as an alternative in clinical practice with minimal risks.

Case report: incarcerated gestational uterine rectal prolapse managed with manual reduction and Thiersch procedure

Introduction and Importance: Incarcerated gestational uterine rectal prolapse is a rare obstetrical complication, with only three other cases reported worldwide. Risk factors for uterine incarceration and anal sphincter deficiency are predisposing factors. The authors report a case of gestational uterine rectal prolapse with successful reduction and prevention, discuss previous approaches and provide recommendations for future cases. Case Presentation: A 33-year-old G5P3 woman presented with a 9 h history of an incarcerated 14-week gestational uterine rectal prolapse, which occurred following a bowel movement. Examination revealed prolapsed rectal lumen containing a gravid uterus with a live fetus demonstrated using point-of-care ultrasound. Under general anesthesia in the left lateral decubitus position, the prolapse was successfully reduced manually and the anal sphincter was secured with a Thiersch perianal encirclement procedure. The pregnancy remained uncomplicated, and she delivered a viable infant via Cesarean section at term. Discussion: This case report is unique in that there have only been three other published reports worldwide and we successfully employ the use manual reduction and placement of a Thiersch encirclement in the management of our case. Manual reduction under general anesthesia in the left lateral decubitus position is noninvasive and was shown to optimally manage gestational uterine rectal prolapse. A Thiersch perianal encirclement procedure coupled with aggressive bowel care was shown to be successful at prevention of recurrence of rectal prolapse in pregnancy following reduction. Conclusion: Manual reduction under general anesthesia and Thiersch encirclement is an effective management for incarcerated gestational rectal prolapse.

Effective non-surgical treatment of hemorrhoids with sclerosing foam and novel injection device

ObjectiveTo determine the effectiveness of a novel protocol to treat patients with hemorrhoidal disease. MethodA retrospective study was conducted of consecutive patients treated for hemorrhoidal disease using a patented sclerosing foam and injection device. ResultsThe protocol was applied in 706 patients between May 2013 and May 2023. After a median of one session, pain and anal bleeding were improved/eliminated in 92–94% of cases and fecal incontinence was resolved in both cases. Reduced prolapse sensation was reported in 81%, with prolapse being improved/eliminated in 63%, although folds were not removed in most prolapse cases. No severe side effects were observed, with mild local post-treatment pain in only 7%. The recurrence rate was very low. DiscussionTreatment with this sclerosing microfoam protocol achieved excellent outcomes, improving/eliminating symptoms in almost all patients. It is not recommended for fold removal. Longer-term studies of wider samples are warranted to verify these results.

Investigation of risk factors for vaginal dehiscence and development of small bowel evisceration after robot-assisted radical cystectomy for female bladder cancer and an improved vaginal reconstruction technique to prevent its onset.

Transvaginal organ prolapse, such as small bowel evisceration, is a rare complication after radical cystectomy (RC) in female patients with invasive bladder cancer, However, it often requires emergency surgical repair. Here, we describe our experience with such a case and a review of similar previously reported cases, along with evaluation of the risk factors. We also propose a vaginal reconstruction technique to prevent this complication during robot-assisted laparoscopic radical cystectomy (RARC). A total of 178 patients who underwent laparoscopic radical cystectomy (LRC) or RARC were enrolled, 34 of whom (19%) were female. One of the 34 female patients had transvaginal small bowel evisceration after RARC. We evaluated our case and six such previously reported cases, to determine vaginal reconstruction techniques during RARC to prevent this complication postoperatively. Median age of these cases was 73 (51-80) years, and all patients were postmenopausal. The median time to small bowel evisceration was 14 (6-120) weeks postoperatively. In addition, we changed the methods of the vaginal reconstruction technique during RARC from the conventional side-to-side closure technique to the improved caudal-to-cephalad closure technique. Since implementing this change, we have not experienced any cases of vaginal vault dehiscence or organ prolapse. Transvaginal small bowel evisceration after RC can easily become severe. Therefore, all possible preventive measures should be taken during RARC. We believe that our vaginal reconstruction techniques might reduce the risk of developing this complication.

PROLAPSUS GENITAUX : ASPECTS EPIDEMIOLOGIQUES DIAGNOSTIQUES ET THERAPEUTIQUES A PROPOS DE 58 CAS.

Genital prolapse is a permanent or stressful exit through the vagina of one or more components of the pelvic viscera. It is frequent in elder, multiparous and menopausal women. Its diagnosis is clinical and the treatment essentially surgical. The recurrent rate is significant. The aim of our study was to describe the epidemiological, diagnostic, therapeutic and prognostic aspects of genital prolapse in the general surgery department of Aristide Le Dantec Teaching Hospital in Dakar. Materials and method. It was a retrospective study interesting genital prolapse operated in the period of 10 years 6 months from January 1, 2008 to July 31, 2019. The studied parameters were epidemiological data, clinical data, classification, paraclinical data, surgical treatment and results. Results. We collected 58 cases of genital prolapse represented 0.55% of the surgical activity during the study period. The mean age was 59 years with extremes of 25 and 89 years. The most represented age group was 61 and 75 years of age with 25 cases (43.1%). Patients over the age of 60 represented 50.1%. We had 46 cases of multiparous (79.3%) and 11 cases of pauciparous (19%). Postmenopausal patients represented 44 cases (75.8%). The majority of our patients, 67.2%, were housewives with the notion of carrying a heavy charge. All of our patients delivered vaginally with 13.3% obstructed labor. Eight patients (13.7%) had a history of pelvic surgery. The mean duration of symptom was 8 months with extremes of 10 days and 40 years. The functional signs were dominated by the sensation of a vaginal mass in 53 cases (91.3%). We had 13 cases of urinary incontinence (22.4%) and all associated with a cystocel. The three-stage genital prolapse was the most frequent (43.1%). The grade III was the most frequent (43.3%). Pelvic ultrasound was performed in 74.1%. The vaginal route was performed in 56 cases (96%). The triple perineal intervention with hysterectomy was the most performed procedure in 23 cases or 41%. Two cases (4%) of uterine promontofixation by laparotomy was done. The mean of hospital stay was 4 days. Morbidity was 4 cases (6.8%) and was dominated by urinary tract infection. Six cases of recurrence were noted (0.3%). Conclusion:Although the clinical diagnosis is easy, management is uncodified and would require the establishment of a well questionnary. Keywords: genital prolapse, urinary incontinence, vaginal surgery

Case report: A case of perineal prolapse of giant uterine fibroids complicated by multiple pulmonary embolisms and deep venous thrombosis

A 43-year-old woman with a history of uterine fibroids, anemia, and deep vein thrombosis presented with a chief symptom of prolapse of tumor from the perineum, complicated by infection. The case was further complicated by bilateral pulmonary multiple embolism, deep vein thrombosis, acute cardiac insufficiency, acute renal insufficiency, and shock. The patient was treated with preoperative placement of an inferior vena cava filter, open hysterectomy, and perioperative anticoagulation with low-molecular-weight heparin. She smoothly navigated the perioperative period and recovered completely.

Extensor tendon rupture and preoperative mri confirmations of suture anchor prolapse: a case report and literature review

BackgroundWhile suture anchors are widely used in medical procedures for their advantages, they can sometimes lead to complications, including anchor prolapse. This article presents a unique case of suture anchor prolapse at the base of the distal phalanx of the little finger after extensor tendon rupture reconstruction surgery.Case presentationA 35-year-old male, underwent extensor tendon rupture reconstruction using a non-absorbable suture anchor. After seven years the patient visited our outpatients complaining of stiffness, pain, and protrusion at the surgical site. Initial X-ray imaging suggested suggesting either a fracture of the distal phalanx or tendon adhesion but lacked a definitive diagnosis. Subsequent magnetic resonance imaging (MRI) revealed bone connectivity between the middle and distal phalanges with irregular signal shadow and unclear boundaries while maintaining a regular finger shape. MRI proved superior in diagnosing prolapsed suture anchors, marking the first reported case of its kind. Surgical intervention confirmed MRI findings.ConclusionsSuture anchor complications, such as prolapse, are a concern in medical practice. This case underscores the significance of MRI for accurate diagnosis and the importance of tailored surgical management in addressing this uncommon complication.

Long-Term Costs of Minimally Invasive Sacral Colpopexy Compared to Native Tissue Vaginal Repair With Concomitant Hysterectomy

Study ObjectiveTo determine the long-term costs of hysterectomy with minimally invasive sacrocolpopexy (MISCP) versus uterosacral ligament suspension (USLS) for primary uterovaginal prolapse repair. DesignA hospital-based decision analysis model was built using TreeAge Pro (TreeAge Software Inc, Williamstown, MA). Those with prolapse were modeled to undergo either vaginal hysterectomy with USLS or minimally invasive total hysterectomy with sacrocolpopexy (MISCP). We modeled the chance of complications of the index procedure, prolapse recurrence with the option for surgical retreatment, complications of the salvage procedure, and possible second prolapse recurrence. The primary outcome was cost of the surgical strategy. The proportion of patients living with prolapse after treatment was the secondary outcome. SettingTertiary center for urogynecology. PatientsFemale patients undergoing surgical repair by the same team for primary uterovaginal prolapse. InterventionsComparison analysis of estimated long-term costs was performed. Measurements and Main ResultsOur primary outcome showed that a strategy of undergoing MISCP as the primary index procedure cost $19 935 and that undergoing USLS as the primary index procedure cost $15 457, a difference of $4478. Furthermore, 21.1% of women in the USLS group will be living with recurrent prolapse compared to 6.2% of MISCP patients. Switching from USLS to MISCP to minimize recurrence risk would cost $30 054 per case of prolapse prevented. Additionally, a surgeon would have to perform 6.7 cases by MISCP instead of USLS in order to prevent 1 patient from having recurrent prolapse. ConclusionThe higher initial costs of MISCP compared to USLS persist in the long term after factoring in recurrence and complication rates, though more patients who undergo USLS live with prolapse recurrence.

Clinical application of middle descending colon-double lumen ostomy with distal stoma narrowing in the treatment of anorectal malformation

BackgroundAnorectal malformations (ARMs) are the most common congenital anomaly of the digestive tract. And colostomy should be performed as the first-stage procedure in neonates diagnosed with intermediate- or high-type ARMs. However, the most classic Pe˜na’s colostomy still has some disadvantages such as complicated operation procedure, susceptibility to infection, a greater possibility of postoperative incision dehiscence, difficulty of nursing and large surgical trauma and incision scarring when closing the stoma. We aimed to explore the effectiveness of middle descending colon-double lumen ostomy (MDCDLO) in the treatment of high and intermediate types of anorectal malformations.MethodsWe retrospectively reviewed the data of patients who underwent MDCDLO for high or intermediate types of ARMs between June 2016 and December 2021 in our hospital. The basic characteristics were recorded. All patients were followed up monthly to determine if any complication happen.ResultsThere were 17 boys and 6 girls diagnosed with high or intermediate types of ARMs in our hospital between June 2016 and December 2021. All 23 patients were cured without complications such as abdominal incision infection, stoma stenosis, incisional hernia, and urinary tract infection in the postoperative follow-up time of 6 months to 6 years except one case of proximal intestinal prolapse was restored under anesthesia.ConclusionMDCDLO offers the advantages of simplicity, efficiency, safety, mild trauma, and small scarring in the treatment of high and intermediate types of anorectal malformations.

Is Stress Urinary Incontinence Symptom Determined by the Severity of Anterior Compartment Prolapse?

Background: Stress urinary incontinence (SUI) and pelvic organ prolapse (POP) would develop simultaneously because of the same etiopathogenesis of pelvic floor weakness. Some studies have said the association between SUI symptoms may be determined by the degree of anterior compartment prolapse. Then some incidences of occult SUI could also mask the symptom of SUI in the severe stage of POP. Methods: A total of 32 women diagnosed with POP and SUI from the urogynecology clinic were included in a cross-sectional study between 2019 and 2020. The degree of anterior compartment prolapse was measured using the POP-Q system (Ba point), while SUI's severity was measured using a 1- hour pad test in grams. The correlation between the severity of SUI (with the occurrence of occult SUI) and the anterior compartment prolapse was analyzed. Results: No correlation was observed between the degree of anterior compartment prolapse and SUI degree (r = 0.240, p = 0.182). Occult SUI was found in only 5/24 (20.8%) grade III and IV anterior compartment prolapse cases. Conclusion: SUI symptom was not determined by the severity of anterior compartment prolapse. The prevalence of occult SUI in severe POP was also low.

A Mystery Unsolved: A Spontaneous Lens and Uveal Prolapse in a New-born

Introduction : Corneal rupture in new-born, especially during the first week of life is rare. Some of these cases occur because of ocular trauma during deliveries, systemic infection, and congenital anomalies. We aim to deliver a rare case of spontaneous lens and uveal prolapse in new-born and management in treating the case.&#x0D; Case Illustration : A-2-day-old full-term-baby was referred due to bleeding of the right eye 6 hours post-partum by spontaneous vaginal delivery with no trauma. The mother, a 23-year-old, having the second born with no history of medical illness or vaginal discharged during pregnancy. Measurements of birth weight and length were normal. Eye examination of the right eye (RE) was uveal and lens prolapse and left eye (LE) cloudy cornea with leukoma and prominent neovascularization. Orbital CT-Scan revealed bilateral vitreous bleeding of both eyes. Laboratory examination showed reactive IgM for herpes simplex virus, reactive IgG for both toxoplasma and rubella. Corneal swab culture was sterile. Systemic and topical antibiotics were administered then switched to systemic antivirus. The 12-day-old-patient showed partial epithelization of cornea, less uveal volume with it partially shrank. Close observation was conducted and evisceration was postponed.&#x0D; Discussion : Although etiologic work-up has been addressed, exact etiology remains unknown with the possibility of congenital cause. It has been postulated that structurally malformed eyes are more prone to corneal perforations. Management should be personalized based on the patient’s need.&#x0D; Conclusion : Thorough examination is vital a rare case with undisclosed aetiology especially new-born. Patient monitoring is sufficient if no infections and bleedings found.

RECTAL PROLAPSE IN LOCAL CATS

Rectal prolapse is a condition when one or more layers of the rectum pass through the anal orifice. Prolapse commonly occurs in young and old animals due to constipation, endoparasites, diarrhea, hereditary factors, loss of anal sphincter power and loosening of the rectal mucous membranes. A black cat with complaints of prolapse, good appetite and active cat. The purpose of the rectal prolapse surgery technique in cats is to improve the patient's condition and provide information about handling cases of rectal prolapse. Physical examination shows that the prolapsed rectum has a bright red color, the proximal part is pink while the distal part is red and shrinks. The blood test results show that the cat is fit for surgery. Pre-surgery, the bleki cat was first fasted to eat for 12 hours and drink for 6 hours. Administration of atropine sulfate premedication at a dose of 0.02 mg/kg BW (SC), sedation using xylazine at a dose of 2 mg/kg BW (IV), and anesthesia using ketamine at a dose of 15 mg/kg BW (IV). Cats were operated on using rectal repositioning technique. The rectum is inserted slowly manually, then suturing is done around the anus with a purse string pattern. Postoperative care was carried out by giving the analgesic tolfedine (4mg/kg BW, SC, q24h), non-steroidal anti-inflammatory pain relievers and the antibiotic cefotaxime (20 mg/kg BW, IV, q12h) to treat bacterial infections and giving betadine after the rectum was repositioned. The cat has rectal prolapse which is thought to be caused by eating dry food or giving hard food which causes the cat to experience tenesmus and often strains when making feces. To avoid recurrent prolapse, cats should be advised not to exercise excessively, cage cats, keep cages and cats clean and moist and replace dry food with soft and watery feed rich in protein.

Pelvic organ prolapse: a cross-sectional study during mass campaign in two hospitals in the city of Kananga in the Democratic Republic of Congo.

pelvic organ prolapse is a dynamic pathology that can worsen or regress especially postpartum and is the basis of several disorders that bother the patient and alter her quality of life. This study aims to determine the epidemiological, clinical, and therapeutic profile of pelvic organ prolapse in the town of Kananga. this is a cross-sectional study of cases of pelvic organ prolapse recorded during the mass campaign organized in the Bon-Berger Hospital of Tshikaji and Saint Georges Hospital of Katoka in the town of Kananga, from January 1 to July 31, 2023. Non-probability convenience sampling was used to select cases. we recorded 138 cases of prolapse out of 572 patients. The prevalence of pelvic organ prolapse is 24.12% with an average monthly incidence of 19.71 (SD: 4.23) cases per month. The prevalence of recurrence of pelvic organ prolapse is 8.69%. The average age of patients is 54.86 (SD: 11.36) years with an average parity of 7.62 (SD: 1.8) deliveries. Its preoperative symptomatology consists of the intravaginal mass associated with digestive and urinary disorders in 97.00% (n=130), stage III hysterocele predominates in 68.70% (n=92), surgical treatment is the most practiced in 91.79% (n=123) and hysterectomy associated with the treatment of cystocele and rectocele by vaginal surgical access is the most practiced in 80.60% (n=108). pelvic organ prolapse is a real public health problem in the city of Kananga, its symptoms are classic and its treatment is surgical via the vaginal route.

A Case of Colostomy Prolapse with Incarceration Treated with the Modified Altemeier Method

A Case of Colostomy Prolapse with Incarceration Treated with the Modified Altemeier Method

Repair surgical techniques in degenerative cardiac valve disease

Background: Re-evaluation of reconstructive possibilities in the correction of degenerative mitral valve disease is of great clinical necessity nowadays. Material and methods: Analyzing the nature of the pathologies that determined the development mechanism of valve insufficiency, 136 cases of anterior cusp prolapse and 152 cases of posterior cusp prolapse were determined. Results: Cord rupture was established in 79 (58.9%) patients, cusp defects (”Cleft”) were appreciated in positions A1, A2, A3 – 15 cases (5.9%) and in P1, P2, P3 – in 92 (86.6%) cases. The surgical techniques performed were separated into: (1) resection – for the anterior and posterior cusps – 45 cases and accompanied by the slide – in 30 cases; (2) with Gore-Tex neo-chordal implantation – 115 cases, with cord transfer – 30; (3) Cusp enlargement with autologous pericardium – 5 cases, Alfieri procedure – 8. Implantation of a support ring required 130 (97.0%) patients. The correction of the associated valve disease required 125 patients (De Vega – 89.1%, ring – 8). Coronary bypass was required – 16 patients. There were no postoperative fatal cases. Conclusions: Based on the data obtained, reconstructive repair surgery can be can recommend for valves of degenerative, post-traumatic, ischemic, post-endocardial etiology as effective and sustainable techniques over time, being a superior alternative to replacement with prosthetic valves.

Urethral Prolapse in a Post-Menopausal Woman at the Sominé Dolo Hospital in Mopti (Mali)

Urethral mucosal prolapse is a rare and benign condition, which consists of a circular eversion of the distal urethral mucosa through the urinary meatus. It occurs most often in prepubertal and postmenopausal women for whom lack of estrogen and poor pelvic support remain the predisposing factors. Its presence in the post-menopausal period is rare. We report a case of urethral prolapse in a postmenopausal woman at the Sominé Dolo hospital in Mopti who presented with persistent urinary symptoms. We present a case of urethral prolapse observed in a 66-year-old woman referred to the urology consultation and who presented recurrent urinary symptoms with multiple treatments based on antibiotics and medicinal plants without success for a year. Physical examination noted a circular, non-reducible and non-painful swelling at the level of the urethral meatus with bleeding on contact, consistent with urethral prolapse. The option of surgical excision was discussed with the patient. The patient underwent surgery and the postoperative course was simple.

Complications during Vaginal Sacrospinous Fixation along with McCall Culdoplasty in Stage III and IV POP

In Bangladesh, about half a million women are suffering from stage III or IV pelvic organ prolapse (POP). With traditional surgical methods, there is a chance of recurrence, especially of apical prolapse. Sacrospinous fixation (SSF) along with MacCall Culdoplasty during vaginal hysterectomy can reduce this recurrence rate enormously. This study was designed to identify, manage as well as to prevent per-/post-operative complications during SSF. The study period was from August 2017 to December 2021 at Kumudini Women’s Medical College and Hospital, Bangladesh. Total 335 stage III and IV utero-vaginal prolapse cases were included in this study. The surgeries performed were vaginal hysterectomy followed by modified McCall Culdoplasty and right-sided vaginal sacrospinous ligament fixation (SSF) along with anterior and posterior fascial closure and perineorrhaphy. A standard data collection sheet was used to record the information. Per-operatively, main complications were hemorrhage (3.57%) due to vessel injury and rectal injury (0.90%). The immediate early postoperative complication was buttock pain (24%). Of these, in 97.53% cases, pain subsided within 6 weeks with analgesic and counselling. Only one patient had recurrence of apical prolapse within 1st week of operation. It should be concluded that with proper knowledge of anatomy and careful surgical technique, most of the complications can be avoided. Bangladesh J Obstet Gynaecol, 2022; Vol. 37(2): 90-97

A case of postmenopausal Nulligravida prolapse with foreign body in situ

A case of postmenopausal Nulligravida prolapse with foreign body in situ