Khaleel M, Ayyad M, Albandak M, C N Khalil N, M A Abu Taleb S. Acute Renal Failure Caused by Undiagnosed Pelvic Organ Prolapse in a Postmenopausal Woman: A Diagnosis Not to Be Missed.
Cureus 2023;
15:e44513. [PMID:
37790056 PMCID:
PMC10544584 DOI:
10.7759/cureus.44513]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2023] [Indexed: 10/05/2023] Open
Abstract
Pelvic organ prolapse (POP) is a common condition mainly affecting postmenopausal women, characterized by the descent of pelvic organs through the vaginal canal. While often asymptomatic, POP can manifest with various symptoms such as a painless bulge or pressure sensation, abdominal pain, urinary complaints, and discomfort during intercourse. Severe cases can lead to urinary tract obstruction, hydronephrosis, and renal dysfunction. This case study presents an elderly female with bilateral severe hydronephrosis and pyelonephritis due to undiagnosed POP. Imaging revealed obstructive uropathy resulting from bilateral ureteric compression caused by cystocele and uterine prolapse. The patient's condition improved with antibiotics and supportive management. A vaginal hysterectomy was performed, which led to the resolution of the urinary tract obstruction. This case emphasizes the importance of considering POP in elderly women with urinary symptoms and the need for proactive screening. It highlights the significance of appropriate management to prevent irreversible renal damage. Different treatment modalities, including surgery and pessaries, are discussed, to emphasize the significance of tailoring treatments to individual patient characteristics.
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