2025 Volume 21 Issue 1 Pages 38-42
We here report a case of robot assisted sacrocolpopexy (RSC) combined with total hysterectomy, which resulted in vaginal stump infection, and the final pathological diagnosis showed endometrioid carcinoma. The patient was 59 years old (gravida two, para two). She presented to a local gynecologist for abnormal genital bleeding. She diagnosed with stageⅢ Pelvic organ prolapse(POP). Transvaginal ultrasound showed endometrial thickening, but endometrial biopsy showed no abnormal findings. Treatment with a ring pessary was attempted, but it was naturally fell out, and the patient was referred to our department for surgery. Additional hysteroscopy performed at our hospital, but the findings were not suggestive of malignant disease, so we diagnosed endometrial polyp. For the stageⅢ POP, we performed RSC with total hysterectomy due to the presence of a lesion in the uterine body. On the third postoperative day, the patient developed a fever, blood tests showed an elevated inflammatory response. Imaging studies diagnosed a vaginal stump infection. Antibiotic therapy was administered, and the patient was discharged on the 16 days after surgery. The final pathological diagnosis was endometrioid carcinoma, stageⅠA. RSC patients with uterine lesions should be informed of the possibility of unexpected malignancy, even with adequate preoperative screening. In addition, when performing a total hysterectomy in combination with RSC, it is important to carefully consider the method of vaginal stump and to implement appropriate perioperative management to reduce the risk of postoperative infections.
