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Federación Mexicana de Ginecología y Obstetricia, A.C.

2019, Number 05

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Ginecol Obstet Mex 2019; 87 (05)

Complications after the treatment of apical prolapse: A case report

Bescós-Santana E, Sanz-López A, Nassar-Melic N, Procas-Ramón B, Gabasa-Gorgas L, Elía-Guedea M, Córdoba-Días de Laspra E

Language: Spanish
References: 16
Page: 334-340
PDF size: 593.77 Kb.


ABSTRACT

Background: Pelvic organ prolapse is a pathology that offers a variety of surgical techniques depending on the type of prolapse and the characteristics of the patient.
Clinical case: Patient of 81 years born in Zaragoza (Spain) with a body mass index of 41kg / m2. It presents moderate hypertension and cardiac arrhythmia in treatment with anticoagulants. Requires treatment with acenocoumarol and antihypertensive in a chronic manner. Among the gynecological antecedents, there are three full-term pregnancies that ended with spontaneous deliveries, the second of them with a birth weight of 4,200gr. In this case, we present an elderly patient who initially presented a rectocele corrected initially using a pessary of the ring. The prolapse evolved presenting a rectoenterocele that required surgical correction. As a consequence of the chosen surgical technique and a frequent complication of the vaginal approach, such as a vaginal cuff hematoma, the patient suffered a vaginal opening through which intestinal contents were herniated. After evaluating the case, a new surgical correction was required that would allow the simultaneous resolution of the hernia through the vaginal wall that presented and the recurrence of the apical prolapse. Today is the right evolution (12 months of the surgical event), asymptomatic and without apparent complications.
Conclusion: Prolapse surgery is complex due to its wide variety of surgical techniques and its high rate of recurrence. It is necessary to be aware of the different approaches to be able to offer the best solutions to our patients.


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