<abstract xmlns="http://www.w3.org/1999/xhtml"><bold>Introduction:</bold> Pelvic floor hernias are encountered especially in elderly women. A combined genital, bladder, and rectal prolapse poses treatment challenges in aged women.<bold>Case presentation:</bold> We present the case of an 88 year-old patient, complaining of an intravaginal mass protruding for the last 3 months, rectal prolapse that occurred two weeks before admittance, accompanied by stress incontinence of urine and chronic constipation. Examination revealed a uterine prolapse with cystocele and a fourth grade rectal prolapse. We decided on a perianal and transvaginal approach, performing preliminary dilatation and curettage, cervix amputation, anterior colporrhaphy and colpoperineorrhaphy (Manchester procedure) with perineal rectosigmoidectomy using the LigaSure™ device, and coloanal manual anastomosis. Postoperatively the patient had no symptoms of stress urinary incontinence, bowel movement resumed in the fourth postoperative day, and the patient was discharged after seven days. One month after surgery the patient has both urinary and fecal continence, with no relapse in pelvic organ prolapse.<bold>Conclusions:</bold> Encountering genital, bladder, and rectal prolapse in the same patient is quite rare, and its treatment can be difficult in aged women. Therefore, a less invasive surgical procedure, using the transvaginal approach, and a genital sparing surgery could be the key in cases like this.</abstract>

Introduction: Pelvic floor hernias are encountered especially in elderly women. A combined genital, bladder, and rectal prolapse poses treatment challenges in aged women.Case presentation: We present the case of an 88 year-old patient, complaining of an intravaginal mass protruding for the last 3 months, rectal prolapse that occurred two weeks before admittance, accompanied by stress incontinence of urine and chronic constipation. Examination revealed a uterine prolapse with cystocele and a fourth grade rectal prolapse. We decided on a perianal and transvaginal approach, performing preliminary dilatation and curettage, cervix amputation, anterior colporrhaphy and colpoperineorrhaphy (Manchester procedure) with perineal rectosigmoidectomy using the LigaSure™ device, and coloanal manual anastomosis. Postoperatively the patient had no symptoms of stress urinary incontinence, bowel movement resumed in the fourth postoperative day, and the patient was discharged after seven days. One month after surgery the patient has both urinary and fecal continence, with no relapse in pelvic organ prolapse.Conclusions: Encountering genital, bladder, and rectal prolapse in the same patient is quite rare, and its treatment can be difficult in aged women. Therefore, a less invasive surgical procedure, using the transvaginal approach, and a genital sparing surgery could be the key in cases like this.

High Grade Uterine and Rectal Prolapse

Surgery Clinic No. I, County Emergency Clinical Hospital, University of Medicine and Pharmacy, Tîrgu Mureș,

Urology Clinic, County Emergency Clinical Hospital, University of Medicine and Pharmacy, Tîrgu Mureș,

Obstetrics and Gynecology Clinic No. 1, County Emergency Clinical Hospital, University of Medicine and Pharmacy, Tîrgu Mureș,

Journal of Interdisciplinary Medicine

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

{"article-title":"High Grade Uterine and Rectal Prolapse"}

Introduction: Pelvic floor hernias are encountered especially in elderly women. A combined genital, bladder, and rectal prolapse poses treatment challenges in...

High Grade Uterine and Rectal Prolapse

Publié en ligne: 23 oct. 2016

Pages: 183 - 185

Reçu: 04 juil. 2016

Accepté: 19 juil. 2016

DOI: https://doi.org/10.1515/jim-2016-0028

Mots clés
anterior colporraphy, cystocele, rectal prolapse, transanal rectosigmoid resection

© 2016 Călin Molnar et al., published by De Gruyter Open

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

High Grade Uterine and Rectal Prolapse

Publié en ligne: 23 oct. 2016

Pages: 183 - 185

Reçu: 04 juil. 2016

Accepté: 19 juil. 2016

DOI: https://doi.org/10.1515/jim-2016-0028

Mots clésanterior colporraphy, cystocele, rectal prolapse, transanal rectosigmoid resection

© 2016 Călin Molnar et al., published by De Gruyter Open

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Mots clés
anterior colporraphy, cystocele, rectal prolapse, transanal rectosigmoid resection