Vaginal Stump Prolapse After Bilateral Nephroureteral Hysterectomy

Case Study

Abstract

Pelvic organ prolapse (POP) has a high risk of recurrence and poses challenges for surgeons in terms of reconstruction.
A 77-year-old woman was admitted to the plastic and reconstructive surgery unit at our hospital. She complained of a mass on the external genitalia that caused pain and effusion. Axial computed tomography (CT) showed a prolapse lesion from the pubic bone to the outside of vagina, which did not affect the pelvic organs. During examination, the patient was found to have ascites due to liver cirrhosis.
Based on clinical and imaging findings, the patient was diagnosed with POP due to increased abdominal pressure from ascites, which was difficult to manage due to the patient undergoing maintenance dialysis. The remaining peritoneal defect was closed and fascia collected from the left thigh was transplanted to close the pelvic floor. A gluteal fold flap was created to fill the defect. One year after the operation, no recurrence was observed, and CT images showed no ascites in the genital area.
These findings suggest that fascia lata transplantation and reconstruction via the gluteal fold flap can effectively counter the increase in intra-abdominal pressure caused by ascites.