Transvaginal repair of enterocele following robot‐assisted radical cystectomy using a mesh for abdominal wall hernia repair

Anterior enterocele after cystectomy: case report and review of the literature

PURPOSE

Anterior enterocele is a rare but potentially serious complication after cystectomy with heterogeneous treatment options.

METHODS

Here we report on the management of a 71-year-old patient with recurrence of anterior enterocele after cystectomy and provide a systematic review of the literature using the PubMed/MEDLINE database.

RESULTS

The 71-year-old patient with recurrence of anterior enterocele after cystectomy was successfully treated with colpocleisis and anterior colporrhaphy at the Department of Gynecology and Gynecological Oncology, University Hospital Bonn. The use of a synthetic mesh was not needed. At 16-month follow-up postoperatively, the patient was asymptomatic and had no signs of recurrence. n = 14 publications including n = 39 patients were identified for the systematic review including case reports and reviews. The median duration of developing an anterior enterocele after cystectomy was 9 months (range 3 months to 8 years). Patients had a median age of 71 years (range 44-84). In all cases, a surgical approach was described using a wide variety of surgical procedures. In total, 36% of all patients developed a recurrence with an average time period of 7 months after primary surgery. A rare complication represents a vaginal evisceration with the need of urgent surgery. Furthermore, the occurrence of a fistula is a possible long-term complication.

CONCLUSION

Anterior enterocele after cystectomy is a rare complication requiring an individual and interdisciplinary treatment.

A case of laparoscopically assisted transperineal repair of anterior enterocele dehiscence with small bowel evisceration after robot-assisted radical cystectomy

We herein report a case of successful laparoscopically assisted transperineal repair of anterior enterocele dehiscence with small bowel evisceration after robot-assisted radical cystectomy. A 75-year-old woman underwent robot-assisted radical cystectomy with anterior vaginectomy and urethrectomy for bladder cancer (pTisN0M0). Vaginal reconstruction was performed using the posterior vaginal wall. Four months after surgery, she presented with small bowel evisceration due to anterior enterocele dehiscence. She underwent laparoscopically assisted transperineal repair. The anterior enterocele dehiscence did not occur at the vaginal closure site but instead between the vaginal wall and posterior pubic bone. No recurrence had developed at 2 months postoperatively.