Vaginal vault evisceration after total laparoscopic hysterectomy.
- Author:
Daehyun PARK
1
;
Hyangjin JEONG
Author Information
1. Department of Obstetrics and Gynecology, Bundang CHA Hospital, CHA University, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Vaginal vault evisceration;
Total laparoscopic hysterectomy
- MeSH:
Ascites;
Coitus;
Fallopian Tubes;
Female;
Hemorrhage;
Humans;
Hysterectomy;
Hysterectomy, Vaginal;
Medical Records;
Omentum
- From:Korean Journal of Gynecologic Endoscopy and Minimally Invasive Surgery
2012;24(2):120-126
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
OBJECTIVE: Fourteen cases of vaginal vault evisceration after total laparoscopic hysterectomy were presented. We review pertinent literature, discuss precipitating causes, clinical manifestations, and management that was performed. METHODS: We reviewed medical records of 14 women with vaginal vault evisceration after total laparoscopic hysterectectom between March 2000 and October 2012 at 4 hospitals of CHA University. RESULTS: Between March 2000 and March 2006, 1,887 women underwent total laparoscopic hysterectomy and 12 vaginal vault eviscerations (0.6%) were presented. Thereafter, only two new cases were presented. The precipitating event was coitus in nine cases (64%), sit-ups in two cases (14%), spontaneous (urine ascites), lymphatic ascites, and unknown in one case (7%) each. Prolapsed organs were small bowels, omentum, and salpinx. Common presenting symptoms were pain, bleeding, watery discharge, and protruded mass (bowels). Eleven women underwent transvaginal repair (79%) - two laparotomic (14%) and one laparoscopic (7%), and none have exhibited sequelae. CONCLUSION: Coitus was the triggering event in most cases. For vaginal vault evisceration following total laparoscopic hysterectomy, vaginal repair should be first considered.
