Post-cystectomy Enterocele: A Case Series and Review of the Literature.

Urology
Alan P CruzAriana L Smith

Abstract

To present a case series and literature review on post radical cystectomy (RC) pelvic organ prolapse (POP) to heighten awareness of the symptoms, imaging findings, and risk factors associated with this complication and discuss opportunities for prevention. Women with muscle invasive bladder cancer undergo RC with anterior exenteration, significantly disrupting the pelvic floor. These women are at risk for POP. We present 4 cases of high-grade POP in women who underwent RC for bladder cancer. We reviewed the literature by conducting a Boolean search in PubMed with the terms "("radical cystectomy") AND ("enterocele" OR "pelvic organ prolapse" OR "rectocele" OR "vaginal vault prolapse")." All 4 women reported a bulge sensation in the vagina and physical exam confirmed POP. Three had radiographic findings consistent with high-grade enterocele at rest. Three experienced prolonged intra-abdominal pressure rise post-RC that may have further weakened pelvic floor support, while the fourth had a history of surgery for high-grade POP. Nine articles on POP following RC were identified. Four focused on treatment and 3 focused on prevention. Administration of a single validated question would have identified all 4 cases of postoperative ent...Continue Reading

References

Sep 23, 2003·Journal of Computer Assisted Tomography·Harpreet K PannuElliot K Fishman
May 6, 2005·International Urogynecology Journal and Pelvic Floor Dysfunction·Jasmine S TanUNKNOWN San Diego Pelvic Floor Consortium
Dec 18, 2008·International Urogynecology Journal and Pelvic Floor Dysfunction·Kobi StavMeny Alcalay
Jul 11, 2012·Female Pelvic Medicine & Reconstructive Surgery·Deborah R KarpG Willy Davila
Jul 12, 2012·Journal of Obstetrics and Gynaecology : the Journal of the Institute of Obstetrics and Gynaecology·H Salem, A El-Mazny
Aug 5, 2016·European Radiology·Rania Farouk El SayedUNKNOWN ESUR and ESGAR Pelvic Floor Working Group
Aug 16, 2016·Current Opinion in Obstetrics & Gynecology·John O L DeLancey
Oct 30, 2016·Urology·Benoit PeyronnetAndrea Manunta
Jan 31, 2017·Current Urology Reports·Steven J Weissbart, Ariana L Smith
Apr 18, 2018·Neurourology and Urodynamics·Gillian StearnsJaspreet Sandhu
Jun 15, 2019·International Urogynecology Journal·Adi Halberthal-CohenLior Lowenstein
Jul 7, 2019·International Urogynecology Journal·David Shaker
Jul 30, 2019·Female Pelvic Medicine & Reconstructive Surgery·Lioudmila LipetskaiaEdward Messing

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