title: Vaginal evisceration 3 years after abdominal hysterectomy and bilateral salpingo-oophorectomy.
abstract: Vaginal evisceration after a pelvic operation is a rare gynecological emergency. When intercourse is the cause, most cases occur within 1 year of surgery. A 53-year-old woman presented to the emergency room for vaginal evisceration half a day after the first postoperative occurrence of intercourse 3 years after an abdominal hysterectomy and bilateral salpingo-oophorectomy. In an emergency laparotomy, the protruding small bowel was replaced within the abdominal cavity. The avulsed vaginal cuff, which measured 6 cm in length and had atrophic but non-necrotic margins, was sutured. Women who go for long periods without intercourse after a hysterectomy, especially post-menopausal women, should be made aware of unrecognized vaginal atrophy that could, in some cases, lead to rupture and evisceration during the next occurrence of intercourse.
authors.affiliation: Department of Obstetrics and Gynecology, National Center for Global Health and Medicine Hospital, Toyama, Shinjuku-ku, Tokyo, Japan. oritos-tky@umin.ac.jp
authors.forename: Seiya
authors.initials: S
authors.lastname: Orito
authors.forename: Norio
authors.initials: N
authors.lastname: Masuya
authors.forename: Ayako
authors.initials: A
authors.lastname: Sakurabashi
authors.forename: Shigeki
authors.initials: S
authors.lastname: Minoura
mesh_terms: D003075:Coitus; D005260:Female; D006547:Hernia; D059685:Herniorrhaphy; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects*; D007421:Intestine, Small; D008875:Middle Aged; D017698:Postmenopause; D014621:Vagina / Q000293:injuries*; D014782:Visceral Prolapse / Q000209:etiology* / Q000601:surgery