title: Vaginal evisceration related to genital prolapse in premenopausal woman.
abstract: Vaginal evisceration is a rare problem, usually related to a previous hysterectomy. We report a case of spontaneous rupture of the cul-de-sac in a premenopausal woman under treatment with glucocorticoids to treat Systemic Lupus Erythematosus (SLE), with uterine prolapse that occurred during evacuation. Main findings-Case Report: A 40-year-old woman with SLE, using glucocorticoids, with uterine prolapse grade 4 (POP-Q), awaiting surgery presented at the emergency room with vaginal bleeding after Valsalva during defection. Uterine prolapse associated with vaginal evisceration was identified. Under vaginal examination, we confirmed the bowel viability and performed a vaginal hysterectomy and sacrospinous fixation. Case hypothesis: This case draws attention to the extreme risk of untreated uterine prolapse, as well as the importance of multidisciplinary care of patients with vaginal prolapse and chronic diseases.
authors.affiliation: Departamento de Obstetrícia e Ginecologia do Hospital São Lucas da Pontifícia Universidade Católica do Rio Grande do Sul, RS, Brasil.
authors.forename: Lucas
authors.initials: L
authors.lastname: Schreiner
authors.affiliation: Departamento de Obstetrícia e Ginecologia do Hospital São Lucas da Pontifícia Universidade Católica do Rio Grande do Sul, RS, Brasil.
authors.forename: Thais Guimarães
authors.initials: TG
authors.lastname: Santos
authors.affiliation: Serviço de Uroginecologia do Hospital São Lucas da Pontifícia Universidade Católica do Rio Grande do Sul, RS, Brasil.
authors.forename: Christiana Campani
authors.initials: CC
authors.lastname: Nygaard
authors.affiliation: Serviço de Uroginecologia do Hospital São Lucas da Pontifícia Universidade Católica do Rio Grande do Sul, RS, Brasil.
authors.forename: Daniele Sparemberger
authors.initials: DS
authors.lastname: Oliveira
mesh_terms: D000328:Adult; D004630:Emergencies; D005260:Female; D006801:Humans; D007044:Hysterectomy; D017697:Premenopause; D014623:Vaginal Diseases / Q000601:surgery*; D014782:Visceral Prolapse / Q000601:surgery*
keywords: Lupus Erythematosus, Systemic; Prolapse; Vagina