An Unusual Case of Vaginal Leak in a Patient on Peritoneal Dialysis

ISPD Peritonitis Recommendations: 2016 Update on Prevention and Treatment

“…A number of other modifiable risk factors for PD peritonitis have been described. Peritonitis has been reported to follow hysteroscopy with biopsy (170) as well as in women with vaginal fistula and leakage (171-174). One retrospective study of 13 gynecological procedures reported a non-significant reduction in peritonitis rates associated with antibiotic prophylaxis (0/4 vs 5/9, p = 0.10) but had inadequate statistical power (161).…”

ISPD Position Statement on Reducing the Risks of Peritoneal Dialysis–Related Infections

“…Hysteroscopy with biopsy can lead to severe peritonitis (100,110). Peritonitis has been reported secondary to a vaginal leak occurring after recurrent peritonitis, leading to formation of a subcompartment in the peritoneal cavity (111), or to a vaginal fistula presenting as a vaginal leak (112,113), and even to a vaginal leak in a prepubescent child on PD (114). Vaginal colonization with Streptococcus agalactiae can be the source of contamination for a female patient or for a male patient who is the partner of a colonized woman (115)(116)(117).…”

Peritoneal Dialysis Guidelines 2019 Part 1 (Position paper of the Japanese Society for Dialysis Therapy)

“…In addition to those previously mentioned, many reports have indicated factors that can be corrected in relation to PD peritonitis. There have been reports of peritonitis onset in females after conducting biopsies with a hysteroscope [604], similar to those seen with vaginal fistulas and leakage [605,606]. Retrospective studies on 13 patients undergoing gynecological treatment indicated that preventative administration of antibacterial drugs was not significant but tended to decrease peritonitis onset [598].…”