TY - JOUR
T1 - Vaginal evisceration after hysterectomy
T2 - A literature review
AU - Ramirez, Pedro T.
AU - Klemer, David P.
N1 - Copyright:
Copyright 2008 Elsevier B.V., All rights reserved.
PY - 2002
Y1 - 2002
N2 - The purpose of this review is to highlight the risk factors, clinical presentation, and different surgical management options for vaginal evisceration after vaginal, abdominal, or laparoscopic hysterectomy. We identified all reports of vaginal evisceration after these procedures using sources in the literature from 1900 to the present. We found that a total of 59 patients were reported, 37 (63%) had a prior vaginal hysterectomy, 19 (32%) had a prior abdominal hysterectomy (2 of which were radical hysterectomy), and 3 (5%) had a prior laparoscopic hysterectomy. The majority of these patients were postmenopausal women. Also, the precipitating event was most often sexual intercourse in premenopausal patients and increased intra-abdominal pressure in postmenopausal patients. In addition, the small bowel was the most common organ to eviscerate. Most of the patients presented with vaginal bleeding, pelvic pain, or a protruding mass. We conclude that vaginal evisceration after hysterectomy remains a rare event. It is more often seen after vaginal hysterectomy than after other types of hysterectomy. It can also occur spontaneously or following trauma or vaginal instrumentation, or any event that increases intra-abdominal pressure. Vaginal evisceration represents a surgical emergency, and the approach to therapy for it may be abdominal, vaginal or a combination of the two.
AB - The purpose of this review is to highlight the risk factors, clinical presentation, and different surgical management options for vaginal evisceration after vaginal, abdominal, or laparoscopic hysterectomy. We identified all reports of vaginal evisceration after these procedures using sources in the literature from 1900 to the present. We found that a total of 59 patients were reported, 37 (63%) had a prior vaginal hysterectomy, 19 (32%) had a prior abdominal hysterectomy (2 of which were radical hysterectomy), and 3 (5%) had a prior laparoscopic hysterectomy. The majority of these patients were postmenopausal women. Also, the precipitating event was most often sexual intercourse in premenopausal patients and increased intra-abdominal pressure in postmenopausal patients. In addition, the small bowel was the most common organ to eviscerate. Most of the patients presented with vaginal bleeding, pelvic pain, or a protruding mass. We conclude that vaginal evisceration after hysterectomy remains a rare event. It is more often seen after vaginal hysterectomy than after other types of hysterectomy. It can also occur spontaneously or following trauma or vaginal instrumentation, or any event that increases intra-abdominal pressure. Vaginal evisceration represents a surgical emergency, and the approach to therapy for it may be abdominal, vaginal or a combination of the two.
UR - http://www.scopus.com/inward/record.url?scp=0036318171&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0036318171&partnerID=8YFLogxK
U2 - 10.1097/00006254-200207000-00023
DO - 10.1097/00006254-200207000-00023
M3 - Review article
C2 - 12172223
AN - SCOPUS:0036318171
SN - 0029-7828
VL - 57
SP - 462
EP - 467
JO - Obstetrical and Gynecological Survey
JF - Obstetrical and Gynecological Survey
IS - 7
ER -