Occult Vaginal Evisceration: Case Report.

BACKGROUND: Vaginal evisceration is a rare gynaecologic emergency that necessitates surgical intervention. It may manifest with obvious vaginal rupture, or it may be occult, specifically in patients with chronic pelvic organ prolapse.

CASE: A 66-year-old woman with a history of bowel cancer and irradiation presented with occult vaginal evisceration. This was discovered during a routine follow-up appointment. It was repaired in two layers with xenograft derived from porcine intestinal mucosa (Surgisis, Cook Medical, Bloomington, IN) interposition and a concomitant colpocleisis. Long-term complications of the procedure included recurrent prolapse, but her vaginal vault evisceration did not recur.

CONCLUSION: In patients with chronic pelvic organ prolapse, especially in those with additional risk factors for poor tissue strength, the possibility of vaginal vault evisceration or dehiscence should be considered. These patients would benefit from close follow-up.