Vaginal Evisceration During Pessary Fitting and Treatment With Immediate Colpocleisis

@article{Rubin2010VaginalED,
  title={Vaginal Evisceration During Pessary Fitting and Treatment With Immediate Colpocleisis},
  author={Rachel S. Rubin and Keisha A. Jones and Ozgur H. Harmanli},
  journal={Obstetrics \& Gynecology},
  year={2010},
  volume={116},
  pages={496-498}
}
BACKGROUND: Complications from pessaries are rare and occur predominantly as a result of neglect and loss to follow-up. We report a case of vaginal evisceration at the time of pessary insertion, which was repaired with concomitant colpocleisis. CASE: An 82-year-old woman with stage IV pelvic organ prolapse (POP) presented for a routine pessary fitting, which resulted in vaginal evisceration and displacement of the pessary into the abdomen. She was treated successfully with immediate… 
Therapy of pessary-induced rectovaginal fistula and pelvic organ prolapse in elderly patients by vaginal approach and modified LeFort colpocleisis: a case series
TLDR
Combined temporary gastrointestinal diversion, RVF closure and POP therapy can be performed as a two- or three-stage approach for rectovaginal fistulas due to pessary perforation.
Rectovaginal Fistula in Women With Pessary for Pelvic Organ Prolapse: A Case Series and Literature Review
TLDR
Although the pessary is commonly indicated for the conservative treatment of pelvic organ prolapse, this device is not exempt from generating complications.
Evisceración intestinal transvaginal secundaria a trauma genital y perineal: presentación de un caso y revisión de la literatura
TLDR
Transvaginal evisceration is a rare occurrence but it is considered to require urgent surgery because of potential complications associated with peritoneal contamination or necrosis and the surgical approach depends on the physical findings and the associated medical conditions.
Introducing an easy new surgical method for repairing vaginal vault prolapse
TLDR
ARLC can be considered as a simple, safe and cost-effective alternative technique for vaginal vault suspension after hysterectomy because of its simplicity, ease of use and low cost.
Delayed post-coital vaginal evisceration of intestines following interval debulking surgery
TLDR
In conclusion the unique case, which is presented here, demonstrates an unusual presentation of colonic carcinoma and the use of imaging before surgery identified a communication between the colon and ovary and allowed for accurate preparation and planning of the surgical procedure.
A Small Bowel Prolapse through Ruptured Vaginal Vault Secondary to Infiltration of a Malignant Tumour in the Region
TLDR
The histology report of the tissue from vaginal vault sent during previous transvaginal vault support and posterior vaginal wall repair is reported as ‘highly suspicious for infiltration of a malignant tumour’ in the region.
Pessary care: follow up and management of complications.
TLDR
Clinical recommendations and evidence related to pessary management of vaginal support pessaries are summarized.
Patterns of Pessary Care and Outcomes for Medicare Beneficiaries With Pelvic Organ Prolapse
TLDR
Pessary can be effectively used for the management of POP in older women despite a low percentage of Medicare beneficiaries undergo pessary fitting, and lack of continuity of care is associated with a small but unacceptable rate of vaginal fistulas.
Retained Viable Single Intrauterine Pregnancy After Vacuum Aspiration for a Dichorionic–Diamniotic Twin Pregnancy
TLDR
There is a role for postoperative ultrasonography in complicated cases such as twin gestations or in very early pregnancies to avoid retained products of conception or the infrequent case of retained viable intrauterine pregnancy.
Intestinal Loop Evisceration after Vaginal Cuff Dehiscence: A Case Report and Review
TLDR
A 94-year-old patient who debuted with vaginal evisceration after vaginal cuff dehiscence is presented, associated with prolonged use of pessary as a treatment for vaginal cuff prolapse and enterocele, after laparotomic hysterectomy.
...
...

References

SHOWING 1-8 OF 8 REFERENCES
Complications of neglected vaginal pessaries: case presentation and literature review
TLDR
An 89-year-old woman presented with a large vesicovaginal fistula resulting from a Gellhorn pessary that had been neglected for 3 years, and the fistula was successfully repaired using the Latzko partial colpocleisis technique.
Bowel evisceration through a ring pessary
A 56 year old postmenopausal woman who had previously undergone posterior repair and sacrospinous fixation of the cervix for uterovaginal prolapse presented with recurrence of the prolapse in January
Large vesicovaginal fistula in women with pelvic organ prolapse: the role of colpocleisis revisited
TLDR
For frail, elderly women with large vesicovaginal fistula and pelvic organ prolapse, addition of LeFort colpocleisis to the repair provides an effective treatment for both.
Total colpocleisis for severe pelvic organ prolapse.
TLDR
Total colpocleisis combined with site-specific reconstructive surgery is an effective and safe treatment of severe pelvic organ prolapse in high-risk, elderly women.
Pelvic support, pelvic symptoms, and patient satisfaction after colpocleisis
TLDR
Colpocleisis was effective in resolving prolapse and pelvic symptoms and was associated with high patient satisfaction, and significantly improved pelvic symptom scores and related bother at 3 and 12 months.
[Vaginal rupture with prolapse of the small intestine].
TLDR
A case of recidival rupture of an enterocele with vaginal rupture and incarceration of small bowel is reported, probably caused by an extreme insufficiency of the patient's connective tissue.