Surgical treatment of complete uterovaginal prolapse and concomitant vaginal cancer: a video case report

Int Urogynecol J. 2020 Aug;31(8):1703-1705. doi: 10.1007/s00192-020-04263-y. Epub 2020 Mar 3.

Abstract

Introduction and hypothesis: The concurrence of vaginal cancer with irreducible uterine prolapse is rare. Reports about the management of vaginal cancer and concomitant irreducible prolapse are scanty in the literature, and there is no consensus on optimal treatment. In this video case report, we show surgical management of vaginal cancer and concomitant stage IV uterovaginal prolapse.

Methods: The featured video shows surgical management of vaginal cancer and concomitant stage IV uterovaginal prolapse through anterior colpectomy and retrograde hysterectomy en bloc plus transvaginal levator ani plication as a non-obliterative native-tissue technique for apical support.

Results: Final examination revealed good apical support and vaginal "habitability" preservation. The patient underwent five sessions of intracavity brachytherapy for a total of 20 Gy as adjuvant therapy.

Conclusion: Surgical management of vaginal cancer and concomitant stage IV uterovaginal prolapse was successfully achieved without complications. Transvaginal levator ani plication can provide a versatile non-obliterative native-tissue technique for apical support, allowing subsequent adjuvant brachytherapy.

Keywords: Levator myorrhaphy; Native tissue repair; Pelvic organ prolapse; Vaginal cancer; Video.

Publication types

  • Case Reports
  • Video-Audio Media

MeSH terms

  • Female
  • Gynecologic Surgical Procedures
  • Humans
  • Pelvic Organ Prolapse*
  • Uterine Prolapse* / complications
  • Uterine Prolapse* / surgery
  • Vaginal Neoplasms* / complications
  • Vaginal Neoplasms* / surgery