Post-cystectomy Enterocele: A Case Series and Review of the Literature

Cruz, Alan Paniagua; Chelluri, Raju; Ramchandani, Parvati; Guzzo, Thomas J.; Smith, Ariana L.

doi:10.1016/j.urology.2020.03.063

Cited by 9 publications

(11 citation statements)

References 19 publications

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“…All publications were case reports or case series of which only two publications included a systematic review of the literature [ 2 , 3 ].…”

Section: Resultsmentioning

confidence: 99%

Anterior enterocele after cystectomy: case report and review of the literature

Schröder,

Plöger,

Knüpfer

et al. 2024

Arch Gynecol Obstet

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Purpose Anterior enterocele is a rare but potentially serious complication after cystectomy with heterogeneous treatment options. Methods Here we report on the management of a 71-year-old patient with recurrence of anterior enterocele after cystectomy and provide a systematic review of the literature using the PubMed/MEDLINE database. Results The 71-year-old patient with recurrence of anterior enterocele after cystectomy was successfully treated with colpocleisis and anterior colporrhaphy at the Department of Gynecology and Gynecological Oncology, University Hospital Bonn. The use of a synthetic mesh was not needed. At 16-month follow-up postoperatively, the patient was asymptomatic and had no signs of recurrence. n = 14 publications including n = 39 patients were identified for the systematic review including case reports and reviews. The median duration of developing an anterior enterocele after cystectomy was 9 months (range 3 months to 8 years). Patients had a median age of 71 years (range 44–84). In all cases, a surgical approach was described using a wide variety of surgical procedures. In total, 36% of all patients developed a recurrence with an average time period of 7 months after primary surgery. A rare complication represents a vaginal evisceration with the need of urgent surgery. Furthermore, the occurrence of a fistula is a possible long-term complication. Conclusion Anterior enterocele after cystectomy is a rare complication requiring an individual and interdisciplinary treatment.

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“…All publications were case reports or case series of which only two publications included a systematic review of the literature [ 2 , 3 ].…”

Section: Resultsmentioning

confidence: 99%

Anterior enterocele after cystectomy: case report and review of the literature

Schröder,

Plöger,

Knüpfer

et al. 2024

Arch Gynecol Obstet

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“… 3 In anterior vaginectomy and urethrectomy, the periurethral fascia and ligamentous support of the pubic symphysis are disrupted. 1 Vaginal reconstruction using the posterior vaginal wall is commonly required following radical cystectomy in women. This female-specific surgical step can lead to vaginal dehiscence.…”

Section: Discussionmentioning

confidence: 99%

“…Pelvic organ prolapse not only impacts quality of life but also has the potential to cause serious complications, including organ evisceration. 1 We consider vaginal dehiscence to be an important cause of the occurrence of anterior enterocele. To avoid vaginal dehiscence, the vaginal wall should be closed very tightly and carefully so that no tension is placed on it.…”

Section: Discussionmentioning

confidence: 99%

“…Radical cystectomy with anterior vaginectomy and urethrectomy disrupts the periurethral fascia and ligamentous support to the pubic symphysis. 1 , 2 Additionally, vaginal reconstruction using the posterior vaginal wall can cause vaginal dehiscence. Therefore, women who have undergone radical cystectomy are more likely to develop pelvic organ prolapse than women who have not undergone this procedure.…”

Section: Introductionmentioning

confidence: 99%

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A case of laparoscopically assisted transperineal repair of anterior enterocele dehiscence with small bowel evisceration after robot-assisted radical cystectomy

Sasaki,

Yamamoto,

Kobayashi

et al. 2024

Urology Case Reports

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“…Although case series of these individual complications have been reported, the actual incidence remains unknown [ 7 , 8 ]. Past studies indicated that vaginal prolapse after RC is probably an underestimated problem that can severely affect the QoL of women postoperatively [ 9 ]. As the focus has been on oncological cure and therapy, the diagnosis and treatment of vaginal prolapse may be delayed or even forgotten [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of sexual function and vaginal prolapse after radical cystectomy in women: a study to explore an under-evaluated problem

et al. 2023

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Introduction and hypothesis The objective was to evaluate sexual function, vaginal prolapse, and quality of life (QoL) in women after radical cystectomy (RC) using validated questionnaires and pelvic organ prolapse quantification (POP-Q) measurement. Methods Female bladder cancer patients who underwent RC at our tertiary care center were included (January 2008 to March 2022). Patients received three validated questionnaires (International Consultation on Incontinence Questionnaire Vaginal Symptoms [ICIQ-VS] Part A, Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire IUGA revised [PISQ], European Organization for Research and Treatment of Cancer Quality of Life Questionnaire [EORTC] C30/BLM30). Patients who consented were examined with vaginal POP-Q measurement. Results Out of 322 patients, 193 were still alive, 54 patients were lost to follow-up, and 43 were excluded, resulting in 96 patients who received the questionnaire. Finally, 35 patients were included, of whom 17 patients consented to vaginal examination. Complaints due to vaginal symptoms were low (ICIQ-VS 6.17 + 5.37). Sexual activity was reported by 12 patients (34.3%); 23 patients (65.71%) were not sexually active. No apical prolapse was found in POP-Q measurement; 6 patients (35.3%) had anterior, and 14 patients (82.4%) posterior prolapse; the highest prolapse stage was 2. No significant differences were found regarding POP stages, sexual function, and QoL (all p > 0.05) when comparing continent and incontinent urinary diversions. Comparing the vaginal approach (no sparing vs sparing), significant differences were found in only two PISQ subscales (significantly higher scores after vagina sparing, p = 0.01 and p = 0.02). Conclusions The type of urinary diversion, POP-Q stages, and tumor stages did not show significant differences regarding sexual function, QoL, and prolapse complaints in women after RC, whereas a vagina- sparing approach showed significant differences only in two subscales without clinical relevance.

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Post-cystectomy Enterocele: A Case Series and Review of the Literature

Cited by 9 publications

References 19 publications

Anterior enterocele after cystectomy: case report and review of the literature

Anterior enterocele after cystectomy: case report and review of the literature

A case of laparoscopically assisted transperineal repair of anterior enterocele dehiscence with small bowel evisceration after robot-assisted radical cystectomy

Evaluation of sexual function and vaginal prolapse after radical cystectomy in women: a study to explore an under-evaluated problem

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