Vaginal hysterectomy and pelvic floor repair for third degree uterovaginal prolapse coexisting with uterine leiomyoma: A case report

Abstract

Genital prolapse occurs when the ligamentous and muscular supports of the uterus weaken from  repeated or difficult vaginal births,  reduced oestrogen secretion from the ovaries after menopause or a  myriad of conditions that increase intrabdominal pressure. It may  coexist with uterine fibroids which are common benign tumours of the uterus. Where the fibroids are large enough, the surgeon must  make a choice on whether the abdominal or vaginal  approach is appropriate for definitive surgical management.  We present a case  report in which we opted for a vaginal approach to perform a hysterectomy for a  symptomatic uterine fibroid in a 45-year-old woman  with a completed family size and coexisting  pathologies of a third degree uterovaginal prolapse and a rectocele with the aim of  highlighting the  challenges of managing such a clinical scenario.

CASE: A case of a third degree uterovaginal prolapse and a rectocele coexisting with a symptomatic 16-week  leiomyoma in a 45-year-old  grand multiparous woman is reported. A vaginal hysterectomy with  repair of rectocele and the pelvic floor resulted in a satisfactory  outcome.