Alice Cola1, Rodolfo Milani2, Alessandro Buda3, Stefano Manodoro4,5, Marta Barba1, Matteo Frigerio2. 1. ASST Monza, Ospedale San Gerardo, University of Milano-Bicocca, Monza, Italy. 2. ASST Monza, Ospedale San Gerardo, Monza, Italy. 3. ASST Monza, Unit of Gynecology Oncology, Ospedale San Gerardo, Monza, Italy. 4. AUSL della Romagna - Ospedale Infermi, Rimini, Italy. stefano.manodoro@gmail.com. 5. U.O. Ostetricia e Ginecologia, Viale Luigi Settembrini 2, 47923, 0541 705211, Rimini, RN, Italy. stefano.manodoro@gmail.com.
Abstract
INTRODUCTION AND HYPOTHESIS: The concurrence of vaginal cancer with irreducible uterine prolapse is rare. Reports about the management of vaginal cancer and concomitant irreducible prolapse are scanty in the literature, and there is no consensus on optimal treatment. In this video case report, we show surgical management of vaginal cancer and concomitant stage IV uterovaginal prolapse. METHODS: The featured video shows surgical management of vaginal cancer and concomitant stage IV uterovaginal prolapse through anterior colpectomy and retrograde hysterectomy en bloc plus transvaginal levator ani plication as a non-obliterative native-tissue technique for apical support. RESULTS: Final examination revealed good apical support and vaginal "habitability" preservation. The patient underwent five sessions of intracavity brachytherapy for a total of 20 Gy as adjuvant therapy. CONCLUSION: Surgical management of vaginal cancer and concomitant stage IV uterovaginal prolapse was successfully achieved without complications. Transvaginal levator ani plication can provide a versatile non-obliterative native-tissue technique for apical support, allowing subsequent adjuvant brachytherapy.
INTRODUCTION AND HYPOTHESIS: The concurrence of vaginal cancer with irreducible uterine prolapse is rare. Reports about the management of vaginal cancer and concomitant irreducible prolapse are scanty in the literature, and there is no consensus on optimal treatment. In this video case report, we show surgical management of vaginal cancer and concomitant stage IV uterovaginal prolapse. METHODS: The featured video shows surgical management of vaginal cancer and concomitant stage IV uterovaginal prolapse through anterior colpectomy and retrograde hysterectomy en bloc plus transvaginal levator ani plication as a non-obliterative native-tissue technique for apical support. RESULTS: Final examination revealed good apical support and vaginal "habitability" preservation. The patient underwent five sessions of intracavity brachytherapy for a total of 20 Gy as adjuvant therapy. CONCLUSION: Surgical management of vaginal cancer and concomitant stage IV uterovaginal prolapse was successfully achieved without complications. Transvaginal levator ani plication can provide a versatile non-obliterative native-tissue technique for apical support, allowing subsequent adjuvant brachytherapy.
Entities:
Keywords:
Levator myorrhaphy; Native tissue repair; Pelvic organ prolapse; Vaginal cancer; Video