Procidentia as a Cause of Obstructive Uropathy and Acute Kidney Injury

Dubowitch, Elliot; Cahn, David; Ross, Curtis; Husain, Ali; Harkaway, Richard C.; Metro, Michael J.; Ginsberg, Philip

doi:10.1159/000365678

Cited by 7 publications

(6 citation statements)

References 6 publications

(11 reference statements)

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“…Although the etiology of bladder calculi remains unknown, the literature suggests that urinary stasis and infection are contributory factors [3]. As a result of urethral kinking and bladder outlet obstruction, uterovaginal prolapse may cause urinary stasis [4]. Similarly, patients with prevalent pelvic organ prolapse exhibit symptoms of the lower urinary tracts, such as an overactive bladder, which may lead to an increase in the thickness of the bladder wall.…”

Section: Discussionmentioning

confidence: 99%

The Surgical Management of Large Bladder Calculi and Irreducible Uterine Prolapse: A Case Report and Review of Literature

Komon,

Saraluck,

Viseshsindh

et al. 2023

Urol Int

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Bladder calculi are rare in women. We report a case of bladder calculi complicating irreducible uterovaginal prolapse. It provides diagnostic and operative challenges to the management team. A 77-year-old woman presented with irreducible complete uterovaginal prolapse. Bladder stones were appreciated on examination and confirmed with imaging. The patient was managed surgically with transabdominal hysterectomy with bilateral uterosacral colpopexy followed by cystolithotomy. The patient’s postoperative course was uncomplicated, and she had an uneventful recovery at her 3-month postoperative visit without a recurrence of prolapse and gained good continence. The presence of bladder calculi should be considered in the setting of irreducible pelvic organ prolapse. The abdominal approach of cystolithotomy with a concomitant hysterectomy and vaginal apical suspension is safe and effective.

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Section: Discussionmentioning

confidence: 99%

The Surgical Management of Large Bladder Calculi and Irreducible Uterine Prolapse: A Case Report and Review of Literature

Komon,

Saraluck,

Viseshsindh

et al. 2023

Urol Int

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“…Pelvic organ prolapse is the herniation of the female pelvic organs (bladder, uterus, small or large bowel, or vaginal cuff post hysterectomy) through or beyond the vaginal walls due to weakened pelvic floor support [ 29 ]. An observational study conducted between 1990 and 2019 suggested the prevalence of POP globally to be around 40%, and the incidence is expected to increase with age [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

Vesical Calculi and Female Pelvic Organ Prolapse: A Case Report and Literature Review

AlSary,

Al-Zahrani,

Al Baalharith

2023

Cureus

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This study presents a case report and reviews the literature on the simultaneous occurrence of advanced uterovaginal prolapse and urolithiasis, aiming to provide a comprehensive analysis of the reported cases. A thorough search was conducted in PubMed and Google Scholar; the search strategy included specific keywords and terms related to both conditions aiming to identify relevant case reports describing the association between advanced uterovaginal prolapse and urolithiasis; a total of 22 case reports were found in English literature. We present a case report of a 56-year-old woman, para 4, presenting with complaints of vaginal bulge and urinary symptoms. Upon examination, a complete procidentia with superficial ulceration was observed. During the reduction of the uterus, multiple small stones were noted coming through the urethral meatus. The patient underwent a vaginal hysterectomy, and the bladder stone was successfully extracted through vaginal cystotomy without complications. Our case report highlights the association between vesical calculi and female high-grade pelvic organ prolapse. Managing bladder stones in the context of pelvic organ prolapse can be challenging and vary significantly, reflecting the individual patient characteristics and surgeon preferences. The lack of standardized guidelines for managing bladder stones in the presence of pelvic organ prolapse highlights the need for further research.

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“…There have been other case reports, including a case described by Dubowitch et al 2 where an elderly demented lady had acute uropathy from urethral obstruction secondary to a procidentia which was managed with manual prolapse reduction and subsequent urethral catheterisation.…”

Section: Introductionmentioning

confidence: 99%

An inventive two-catheter technique to manage an extra-peritoneally ruptured and prolapsed bladder causing obstructive uropathy

O'Halloran

McCombie

Hayne

2019

Urology Case Reports

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An 84 year-old lady presented with extraperitoneal bladder rupture following a fall, in the setting of procidentia causing longstanding bilateral ureteric obstruction. Imaging demonstrated that while part of her bladder was in the pelvis, a large component was within the prolapse. After catheterising the pelvic portion, CT Cystogram confirmed decompression of the bladder in the pelvis, but on-going distension of the bladder in the prolapse. A second urethral catheter was placed in to the prolapsed portion of the bladder facilitating easy manual reduction of the prolapse. This reduction resolved the ureteric obstruction and was maintained with a pessary.

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Procidentia as a Cause of Obstructive Uropathy and Acute Kidney Injury

Cited by 7 publications

References 6 publications

The Surgical Management of Large Bladder Calculi and Irreducible Uterine Prolapse: A Case Report and Review of Literature

The Surgical Management of Large Bladder Calculi and Irreducible Uterine Prolapse: A Case Report and Review of Literature

Vesical Calculi and Female Pelvic Organ Prolapse: A Case Report and Literature Review

An inventive two-catheter technique to manage an extra-peritoneally ruptured and prolapsed bladder causing obstructive uropathy

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