Vaginal cuff dehiscence with adnexal mass evisceration after abdominal hysterectomy

Abstract

INTRODUCTION: More commonly, a vaginal cuff dehiscence is a complication of robotic or laparoscopic hysterectomy while dehiscence is less commonly observed following total abdominal or vaginal hysterectomies. PRESENTATION OF CASE: Three years after an uncomplicated total abdominal hysterectomy for fibroid uterus, a 50 year old female with a known, large adnexal mass presented with vaginal cuff dehiscence and prolapse of the adnexal mass through the vaginal cuff. DISCUSSION: We discuss surgical risk factors including route of hysterectomy, method of colpotomy and vaginal cuff closure as contributing factors for vaginal cuff dehiscence in our patient. CONCLUSION: Any large pelvic mass that may potentially exert pressure necrosis on the vaginal cuff, even remote from hysterectomy may result a vaginal cuff dehiscence. Emergent surgical intervention is warranted.