Vaginal evisceration 3 years after abdominal hysterectomy and bilateral salpingo‐oophorectomy

Abstract

Vaginal evisceration after a pelvic operation is a rare gynecological emergency. When intercourse is the cause, most cases occur within 1 year of surgery. A 53-year-old woman presented to the emergency room for vaginal evisceration half a day after the first postoperative occurrence of intercourse 3 years after an abdominal hysterectomy and bilateral salpingo-oophorectomy. In an emergency laparotomy, the protruding small bowel was replaced within the abdominal cavity. The avulsed vaginal cuff, which measured 6 cm in length and had atrophic but non-necrotic margins, was sutured. Women who go for long periods without intercourse after a hysterectomy, especially post-menopausal women, should be made aware of unrecognized vaginal atrophy that could, in some cases, lead to rupture and evisceration during the next occurrence of intercourse.

Omentectomy with Vaginal Approach and Vaginal Repair as a Treatment of Omental Prolapse After Postcoital Vaginal Vault Rupture: Case Report

“…10 Vaginal evisceration occurs usually within the first year after the operation but could be seen many years after the operation as well. 11 Atrophic vagina can be a risk factor for the situation however it could be seen in premenopausal patients and in patients using estrogen replacement therapy. 9,12 Other known risk factors are poor technique, postoperative infection, hematoma, coitus before healing, advanced age, radiotherapy, corticosteroid therapy, penetrative trauma or rape, previous vaginoplasty, use of the Valsalva maneuver, pelvic radiation, hypoestrogenism, and devascularization from previous surgery.…”