Cover Image
QR Code

Staged repair of concomitant rectovaginal fistula and pelvic organ prolapse after removal of a neglected pessary.

Rectovaginal fistulas are a rare complication of neglected pessaries and can pose challenges in managing pelvic organ prolapse. We describe a 66-year-old woman with uterine procidentia who presented with a neglected Gellhorn pessary in place for 5 years. She complained of constipation and persistent...

Full description

Published in:Baylor University Medical Center Proceedings Vol. 33; no. 4; pp. 686 - 689
Main Authors: Mathews, Stacy, Laks, Shaked, LaFollette, Carola, Montoya, T. Ignacio, Maldonado, Pedro A.
Format: algorithm case study diagnostic images pictorial Journal Article
Published: Taylor & Francis Ltd Oct-Dec2020
Online Access:View this record in EBSCOhost
fields @attributes:
  recordID: 1
pdfLink:
plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=146318450&site=ehost-live
header:
  @attributes:
    shortDbName: ccm
    uiTerm: 146318450
    longDbName: CINAHL Complete
    uiTag: AN
  controlInfo:
    bkinfo:
    dissinfo:
    jinfo:
      jid:
        08998280
        1XEP
      jtl: Baylor University Medical Center Proceedings
      issn: 08998280
      maglogo: N
    pubinfo:
      dt: Oct-Dec2020
      vid: 33
      iid: 4
      pid: 377
      pub: Taylor & Francis Ltd
      place: Philadelphia, Pennsylvania
    artinfo:
      ui:
        146318450
        145549980
        146318450
        146318450
        10.1080/08998280.2020.1792818
        146318450
      ppf: 686
      ppct: 3
      formats:
        fmt:
          – @attributes:
              type: T
          – @attributes:
              type: P
      tig:
        atl: Staged repair of concomitant rectovaginal fistula and pelvic organ prolapse after removal of a neglected pessary.
      aug:
        au:
          Mathews, Stacy
          Laks, Shaked
          LaFollette, Carola
          Montoya, T. Ignacio
          Maldonado, Pedro A.
        affil: Department of Obstetrics and Gynecology, Division of Female Pelvic Medicine and Reconstructive Surgery, Texas Tech University Health Sciences Center–El Paso, El Paso, Texas
      sug:
        subj:
          Pessaries Adverse Effects
          Pelvic Organ Prolapse Surgery
          Fistula Surgery
          Aged
          Female
          Constipation Etiology
          Foreign-Body Migration
          Foreign-Body Removal
          Ileostomy
          Hysterectomy, Vaginal
          Aged: 65+ years
          Female
      ab: Rectovaginal fistulas are a rare complication of neglected pessaries and can pose challenges in managing pelvic organ prolapse. We describe a 66-year-old woman with uterine procidentia who presented with a neglected Gellhorn pessary in place for 5 years. She complained of constipation and persistent vaginal bulge. On examination, the pessary stem eroded through the mid-posterior vaginal wall and anterior rectal wall. Staged surgical treatment included (1) pessary removal and development of ileostomy, (2) rectovaginal fistula repair, and (3) vaginal hysterectomy, uterosacral ligament suspension, and ileostomy reversal. Short-term follow-up did not demonstrate evidence of fistula or recurrence of prolapse. Rectovaginal fistulae resulting from neglected pessaries pose challenges in managing concomitant vaginal prolapse. A staged approach to fistula and prolapse repair is possible with the potential for good outcomes.
      pubtype: Academic Journal
      doctype:
        algorithm
        case study
        diagnostic images
        pictorial
        Journal Article
      ougenre: Article
    language: English
    refInfo:
    holdings:
      @attributes:
        islocal: N