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Prolapse, Urogynecology & Infections

Question
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A 59-yrs-old woman undergoes vaginal hysterectomy and anteroposterior repair for uterine prolapse. Which of the following is a complication of this procedure that often develops within 2 weeks of surgery? (DNB Dec 2010)



A Dyspareunia

B Stress urinary incontinence

C Non fistulous fecal incontinence

D Enterocele

Ans. B

Stress urinary incontinence

1. Many patients who have uterine prolapse or a large protuberant cystocele will be continent because of urethra obstruction caused by the cystocele or prolapse. In fact, at times these patients may need to reduce the prolapse in order to void.

2. Following surgical repair, if the urethrovesical junction is not properly elevated, urinary incontinence may result.

a. This incontinence may present within the first few days following surgery.

b. Dyspareunia can be caused by shortening of the vagina or constriction at the introitus after healing is complete.

c. If the vaginal vault is not properly suspended and the uterosacral ligaments plicated, vaginal vault prolapse or enterocele may occur at a later date.

d. Fecal incontinence is not a complication of vaginal hysterectomy with repair. It may occur, however, if a fistula is formed through unrecognized damage to the rectal mucosa.

Prolapse, Urogynecology & Infections Flashcard List

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