Abstract
We describe a case of a postmenopausal woman with a corrected bladder exstrophy (BE) who presented with a uterovaginal prolapse complicated by calcified fibroids and discuss its surgical management. A 51-year-old woman presented with a uterovaginal prolapse. She had previously had one full term delivery by caesarean section 20 years ago. She had an ileal conduit performed for her BE at birth. A computed tomography scan revealed significant pelvic anomaly and the uterus contained multiple calcified fibroids. Due to the complexity of her condition the surgical management was planned in two stages: initial examination under anaesthetic in conjunction with a consultant urologist and then the definitive planned reconstructive surgery. This case describes the need for careful evaluation and planning of complex surgery and the successful surgical management option for correction of uterovaginal prolapse in patients with BE. A vaginal approach seemed to be a most sensible route to correct the prolapse in view of her previous multiple abdominal surgeries.
References
Nelson CP, Dunn RL, Wei JT, Gearhart JP (2005) Surgical repair of bladder exstrophy in the modern era: contemporary practice patterns and the role of hospital case volume. J Urol 174(3):1099–1102
Bartelink LR, Feitz WF, Kluivers KB, Withagen MIJ, Vierhout ME (2011) Surgical treatment of uterine prolapse in women with bladder exstrophy: report of two cases with modified Prolift™ procedure. Int Urogynecol J 22(7):889–891
Muir TW, Aspera AM, Rackley RR, Walters MD (2004) Recurrent pelvic organ prolapse in a woman with bladder exstrophy: a case report of surgical management and review of the literature. Int Urogynecol J Pelvic Floor Dysfunct 15(6):436–438
Barr S, McLennan M (2008) The anatomic and surgical challenge of treating a patient with stress incontinence, uterovaginal prolapse, and a history of congenital bladder exstrophy. J Pelvic Med Surg 14(4):449
Boemers TM, Schimke CM, Ludwikowski B, Ardelean MA (2005) Rotundum psoas hitch: a new method for colpohysteropexy in girls with bladder exstrophy. J Pediatr Urol 1(5):337–341. doi:10.1016/j.jpurol.2005.02.004
Conflicts of interest
None.
Consent
Written informed consent was obtained from the patient for publication of this case report and any accompanying images.
Author information
Authors and Affiliations
Corresponding author
Electronic supplementary material
Below is the link to the electronic supplementary material.
ESM 1
(MP4 9488 kb)
Rights and permissions
About this article
Cite this article
Israfil-Bayli, F., Belal, M. & Toozs-Hobson, P. Bladder exstrophy combined with uterovaginal prolapse and its surgical management: case report and literature review. Int Urogynecol J 25, 989–991 (2014). https://doi.org/10.1007/s00192-013-2285-6
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00192-013-2285-6