López-Talavera V, Rivas-Penilla L, Ramírez-Isarraraz C, Rodríguez-Colorado S, Granados-Martínez V, Gorbea-Chávez V

Language: Spanish
References: 11
Page: 174-179
PDF size: 267.40 Kb.

ABSTRACT

Background: Childbirth is an important risk factor for pelvic floor trauma and dysfunction. Perineal injuries are of the order of 6% and anterior vaginal tears, with urethral injury, account for 5.5%.
Objective: To report the surgical procedure of a patient with pelvic floor dysfunction secondary to tears in the birth canal.
Clinical case: 25-year-old patient who presented for consultation due to pelvic pain, continuous urinary and fecal incontinence with a history of laceration of the right wall of the vagina and urethra with a transpartum III C perineal tear. Diagnostic studies of cystoscopy and retrograde cystourethrography showed a severe perineal tear together with urethral trauma. With previous knowledge, surgical intervention was decided to perform: vaginoplasty, reconstructive urethroplasty, closure of the ischiorectal fossa with perineoplasty and anal sphincteroplasty. Even with the above, the patient continued with stress urinary incontinence, for which reason a retropubic midurethral tape was placed four months later. At 12 months follow-up she remained with urinary and fecal continence, remission of pelvic pain and no dyspareunia.
Conclusions: Pelvic floor disorders should be evaluated by trained medical personnel for indicated intervention.

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