title: An unusual complication after vaginal hysterectomy.
abstract: BACKGROUND
  uterovaginal prolapse is a common problem in older women, with significant economic and health implications. For the patient no longer desiring fertility or unwilling to undergo conservative management, the definitive treatment is a vaginal hysterectomy with simultaneous repair of anterior or posterior compartment defects if present.
  
  
  METHODS
  A 66-year-old postmenopausal woman with procidentia, cystocele, rectocele, and latent stress incontinence underwent vaginal hysterectomy, anterior and posterior colporrhaphy, and placement of a modified mid-urethral sling. Perioperatively she sustained a fracture of the pubic ramus that was not explained by perioperative events or her medical history.
  
  
  CONCLUSIONS
  unusual and unexpected complications can occur after routine vaginal surgery in the older, postmenopausal population.
authors.affiliation: Department of Obstetrics, Gynecology and Reproductive Sciences, University of Manitoba, Winnipeg, MB.
authors.forename: Tarek S
authors.initials: TS
authors.lastname: Arab
authors.affiliation: Department of Obstetrics, Gynecology and Newborn Care, The Ottawa Hospital, Ottawa, ON.
authors.forename: Amy
authors.initials: A
authors.lastname: Nakajima
mesh_terms: D000368:Aged; D005260:Female; D050723:Fractures, Bone / Q000175:diagnosis*; D006801:Humans; D007045:Hysterectomy, Vaginal / Q000009:adverse effects*; D007431:Intraoperative Complications; D008279:Magnetic Resonance Imaging; D017698:Postmenopause; D011630:Pubic Bone / Q000293:injuries*; D014057:Tomography, X-Ray Computed; D014550:Urinary Incontinence, Stress / Q000601:surgery; D014596:Uterine Prolapse / Q000601:surgery