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Carbone L, Webber V, Rothenberger R, Lenger SM, Gupta A, Messer J, Francis S. Robotic Vaginal Hernia Repair for Recurrent Vaginal Prolapse Status Post-Radical Cystectomy with an Indiana Pouch. Int Urogynecol J 2024; 35:1097-1099. [PMID: 38472342 DOI: 10.1007/s00192-024-05755-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 02/08/2024] [Indexed: 03/14/2024]
Abstract
INTRODUCTION AND HYPOTHESIS Pelvic organ prolapse following a radical cystectomy is challenging to treat and recurrence of prolapse after primary repair is common owing to compromised pelvic floor support and tissue quality. Vaginal prolapse repairs are often preferred because of concern for patients' complex intraabdominal pathological conditions. However, for those with recurrent prolapse following colpocleisis, limited definitive treatment options exist. METHODS This surgical video presents a 64-year-old G4P4 with a history of radical cystectomy with an Indiana Pouch for invasive urothelial carcinoma who presented with recurrent stage IV vaginal prolapse two years following colpocleisis. Owing to thin vaginal tissue, a sacrocolpopexy with vaginal mesh could not be performed, thus, the patient underwent robotic-assisted vaginal hernia repair with a polypropylene-reinforced ovine tissue matrix attached to Cooper's ligament and the levator ani muscles. RESULTS The surgery was free from complications and her postoperative Pelvic Organ Prolapse Quantification examination revealed a leading vaginal tissue remnant at the level of the hymen. The patient reported overall improved health and quality of life following surgery and recovery on postoperative validated questionnaires. CONCLUSIONS Vaginal and pelvic floor hernia repair with a polypropylene-reinforced tissue matrix is a feasible definitive surgical treatment for patients with prior radical cystectomy in whom colpocleisis has failed.
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Affiliation(s)
- Laurel Carbone
- Department of Obstetrics, Gynecology, and Women's Health, Division of Urogynecology, Female Pelvic Medicine, and Reconstructive Surgery, University of Louisville, 550 South Jackson Street, Louisville, KY, 40202, USA.
| | - Victoria Webber
- Department of Obstetrics, Gynecology, and Women's Health, University of Louisville, Louisville, KY, USA
| | - Rodger Rothenberger
- Department of Obstetrics, Gynecology, and Women's Health, Division of Urogynecology, Female Pelvic Medicine, and Reconstructive Surgery, University of Louisville, 550 South Jackson Street, Louisville, KY, 40202, USA
| | - Stacy M Lenger
- Department of Obstetrics, Gynecology, and Women's Health, Division of Urogynecology, Female Pelvic Medicine, and Reconstructive Surgery, University of Louisville, 550 South Jackson Street, Louisville, KY, 40202, USA
| | - Ankita Gupta
- Department of Obstetrics, Gynecology, and Women's Health, Division of Urogynecology, Female Pelvic Medicine, and Reconstructive Surgery, University of Louisville, 550 South Jackson Street, Louisville, KY, 40202, USA
| | - Jamie Messer
- Department of Urology, Urologic Oncology, University of Louisville, Louisville, KY, USA
| | - Sean Francis
- Department of Obstetrics, Gynecology, and Women's Health, Division of Urogynecology, Female Pelvic Medicine, and Reconstructive Surgery, University of Louisville, 550 South Jackson Street, Louisville, KY, 40202, USA
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Sasaki Y, Yamamoto Y, Kobayashi S, Nishi M, Takahashi M, Furukawa J. A case of laparoscopically assisted transperineal repair of anterior enterocele dehiscence with small bowel evisceration after robot-assisted radical cystectomy. Urol Case Rep 2024; 52:102629. [PMID: 38146484 PMCID: PMC10749254 DOI: 10.1016/j.eucr.2023.102629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 11/20/2023] [Accepted: 11/22/2023] [Indexed: 12/27/2023] Open
Abstract
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.
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Affiliation(s)
- Yutaro Sasaki
- Department of Urology, Tokushima University Graduate School of Biomedical Sciences, 3-18-15 Kuramoto, Tokushima, 770-8503, Japan
| | - Yasuyo Yamamoto
- Department of Urology, Tokushima University Graduate School of Biomedical Sciences, 3-18-15 Kuramoto, Tokushima, 770-8503, Japan
| | - Saki Kobayashi
- Department of Digestive Surgery and Transplantation, Tokushima University Graduate School of Biomedical Sciences, 3-18-15 Kuramoto, Tokushima, 770-8503, Japan
| | - Masaaki Nishi
- Department of Digestive Surgery and Transplantation, Tokushima University Graduate School of Biomedical Sciences, 3-18-15 Kuramoto, Tokushima, 770-8503, Japan
| | - Masayuki Takahashi
- Department of Urology, Tokushima University Graduate School of Biomedical Sciences, 3-18-15 Kuramoto, Tokushima, 770-8503, Japan
| | - Junya Furukawa
- Department of Urology, Tokushima University Graduate School of Biomedical Sciences, 3-18-15 Kuramoto, Tokushima, 770-8503, Japan
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Managing Pelvic Organ Prolapse After Urinary Diversion or Neobladder. CURRENT BLADDER DYSFUNCTION REPORTS 2023. [DOI: 10.1007/s11884-023-00685-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
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