Small intestine prolapse after vaginal hysterectomy with vaginal dome rupture. A clinical case

Abstract

The relevance of surgical treatment of pelvic organ prolapse is beyond doubt, due to the high prevalence and risk of surgical intervention during life. Surgical treatment of prolapse today remains the only effective method, however, despite more than 400 methods of surgical correction, the number of complications and relapses does not tend to decrease. This article presents a clinical case of ineffective choice of surgical treatment of genital prolapse with own tissues and vaginal hysterectomy, which subsequently led to the development of enterocele. In the future, the lack of postoperative follow-up and the preservation of a lifestyle that included the performance of hard physical labor led to a rupture of the dome of the vagina and prolapse of the loops of the small intestine. Today, for the prevention of complications and recurrence of genital prolapse, it is mandatory for patients to go through a careful selection for surgical treatment, which should include a clinical study and study of risk factors. When choosing an operative approach, complex treatment is necessary, including the use of the patients own tissues and modern materials that allow creating a reliable physiological framework to strengthen the pelvic organs. When performing this surgery, it is necessary not only to replace the damaged defective pelvic fascia with a new one, but also to create a neofascia that ensures the preservation of the normal function of the pelvic organs.