Vaginal cuff dehiscence and evisceration 11 years after a radical hysterectomy: A case report

Abstract

HighlightsVaginal cuff dehiscence (VCD) and evisceration (VCDE) is a rare but rather serious complication of any type of hysterectomy.The overall incidence was ranged betwenn 0% and 7,5%.Historically, laparotomy was recommended for VCD repair.In our case we choosed to add a Polyglactine mesh and in the limit of our review it’s the only case reported.

Vaginal cuff dehiscence following controlled ovarian stimulation recognized during egg retrieval

“…The literature describes dehiscence to occur typically 6 weeks to 4 months post hysterectomy [5]. However, sporadic cases have been reported 3 years and even up to 11 years after surgery [6]. In postmenopausal women, chronic pelvic organ prolapse and an increase in abdominal pressure play a major role [4].…”

Microscopic Omental Metastasis in Type II Endometrial Cancer Clinically Confined to the Uterus

“…In elderly patients who are no longer interested in having vaginal intercourse this is a good option for treatment as it eliminates the possibility of another cuff dehiscence. For patients who still desire the ability to have vaginal intercourse, several other methods of cuff repair after dehiscence have been reported, such as repair with absorbable suture and omental flap, continuous locking stitches with polyglactin, the use of overlying polyglatcin mesh, and multiple figure of eight sutures of polyglactin, [1,2,5]. One case report of dehiscence 17-years after hysterectomy described the repair of the initial dehiscence vaginally with a double layer cuff closure using polyglactin.…”

“…Vaginal cuff dehiscence and eviscerations are rare but serious complications of hysterectomy, which are defined as the partial or total separation of the vaginal cuff with protrusion of abdominal and/or pelvic contents into the vagina [1]. The incidence of vaginal cuff dehiscence varies based on the method of hysterectomy with 1-4% occurrence after laparoscopic/robotic approach vs. 0.14-0.27% occurrence with vaginal and open abdominal approach [2,3].…”

Impact on Ovarian Reserve after Minimally Invasive Single-Port Laparoscopic Ovarian Cystectomy in Patients with Benign Ovarian Cysts: A Review of the Literature

“…The incidence of vaginal cuff dehiscence varies based on the method of hysterectomy with 1-4% occurrence after laparoscopic/robotic approach vs. 0.14-0.27% occurrence with vaginal and open abdominal approach [2,3]. The even rarer subset of this complication, evisceration through the vaginal cuff, occurs approximately 0.03-1.2% of the time and can include pelvic and abdominal organs such as the small bowel, omentum, fallopian tubes, and/or appendix [1][2][3].…”