Case of vaginal cuff dehiscence and small bowel evisceration after laparoscopic radical cystectomy

Abstract

Introduction Vaginal cuff dehiscence and small bowel evisceration after laparoscopic radical cystectomy, although rare, can be a critical complication. However, little has been reported about it by urologists. Case presentation A 79‐year‐old woman underwent laparoscopic radical cystectomy for invasive bladder carcinoma. Thirteen months postoperatively, she experienced vaginal cuff dehiscence and small bowel evisceration, and underwent emergency surgery. Intraoperatively, we detached the vaginal apex from the surrounding tissue to lengthen it and performed vaginal uterosacral ligament suspension, with no subsequent recurrence. Conclusion Urologists should pay attention to vaginal cuff dehiscence and small bowel evisceration after laparoscopic radical cystectomy in female patients. In this case, the short vaginal length without vaginal uterosacral ligament suspension might have led to vaginal dehiscence.

Prevention and management of vaginal cuff dehiscence: an updated review

“…Though there is no consensus on the most optimal route of repair, minimally invasive approaches (vaginal, laparoscopic, or combination) have become the predominant method of management in recent literature, with laparotomy reserved for patients with hemodynamic instability or necrotic bowel [1,2,11,37,38,[41][42][43][44][45].…”