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| Enormous Uterine Prolapse: A Case Report
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BENAMAR Mohammed, ALAOUI MHAMMEDI Nabil, BENAMAR Ali, AHSSAINI Mustapha, MELLAS Soufiane, TAZI Mohamed Fadl, EL AMMARI Jalal Eddine, EL FASSI Mohammed Jamal, FARIH Moulay Hassan.
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Abstract:
: Female genital prolapse can be defined as a hernia in the vaginal cavity (colpocele) in which one or more elements of the pelvic contents become involved. Organs from all three pelvic compartments may be involved: - In front, anterior colpocele (known as cystocele because it contains the bladder). - Middle or apical compartment: the uterus (hysteroptosis) or the vaginal fundus (prolapse of the vaginal fundus) if the patient has had her uterus removed. - Posteriorly, posterior colpocele which may contain the rectum (rectocele) or the peritoneal cul-de-sac (elytrocele) with abdominal contents (intestine, omentum). The most specific symptom and the one best correlated with the existence of a prolapse is the vaginal ball perceived or felt by the patient. Pelvic heaviness and urinary symptoms are frequently associated with genital prolapse. The most frequently reported urinary symptoms are overactive bladder syndrome, dysuria and stress urinary incontinence (SUI), although these are not specific to prolapse and a high stage prolapse may mask SUI. Our patient presented with pelvic heaviness associated with stress urinary incontinence. Conservative treatments may provide significant improvement without the need for surgery, or may be offered in combination with, in addition to, or pending surgical management. Surgery may be performed vaginally or via an upper approach using a synthetic plate, either by open surgery or laparoscopy. Our patient had undergone open promontofixation with the insertion of a synthetic polypropylene plate. Postoperative recovery was straightforward.
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