Vaginal evisceration after hysterectomy managed by a laparoscopic approach

Abstract

Vaginal evisceration is a rare complication after total hysterectomy. However, there is significant potential for morbidity and mortality if vaginal evisceration is not corrected in a rapid fashion. Vaginal evisceration presents with vaginal bleeding, pelvic pain, and a protruding mass and represents a surgical emergency. Vaginal evisceration is usually managed by abdominal, vaginal, or combined approaches, and recently laparoscopically. The laparoscopic approach has several advantages, including a rapid postoperative recovery and early discharge due to avoidance of a laparotomy. Other advantages of laparoscopy compared with the vaginal approach include assessment of the viability of bowel and inspection for other visceral injuries. We report a case involving a laparoscopic repair of vaginal evisceration in a 52-year-old premenopausal woman 3 months after an abdominal hysterectomy. This case shows the value of laparoscopy in the management of vaginal evisceration.