Vaginal cuff dehiscence following transvaginal oocyte retrieval: a case report
| Autor: | David A. Ryley, Sarah K. O’Connor, Charles W Obasiolu, Wendy Kuohung, Christine C. Skiadas, Katharine M. Esselen |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Infertility
medicine.medical_specialty Vaginal cuff dehiscence media_common.quotation_subject medicine.medical_treatment lcsh:Medicine Fertility Case Report Dehiscence 03 medical and health sciences 0302 clinical medicine Endometrial cancer medicine Vaginal oocyte retrieval 030212 general & internal medicine Fertility preservation media_common lcsh:RT1-120 030219 obstetrics & reproductive medicine Hysterectomy Transvaginal oocyte retrieval lcsh:Nursing business.industry lcsh:R lcsh:RJ1-570 lcsh:Pediatrics medicine.disease Surgery Cuff business |
| Zdroj: | Fertility Research and Practice Fertility Research and Practice, Vol 6, Iss 1, Pp 1-4 (2020) |
| ISSN: | 2054-7099 |
| Popis: | Background Vaginal cuff dehiscence (VCD) is a rare but potentially serious complication following hysterectomy with an estimated incidence of 0.14–1.4%. There is a wide range of risk factors thought to contribute to VCD, but due to its rare occurrence, much still remains to be learned about the true impact of risk factors leading to dehiscence. We present here the second known report of VCD to occur in a patient undergoing transvaginal oocyte retrieval during her fertility treatment. This case highlights what may become a more common clinical scenario as more premenopausal women are diagnosed with reproductive tract cancers and access assisted reproductive therapies to preserve fertility. Case presentation Our patient is a 35-year-old G1 P0 A1 who had undergone ovary-sparing total laparoscopic hysterectomy (TLH) following diagnosis of endometrial adenocarcinoma. She underwent two in-vitro fertilization (IVF) cycles after TLH to bank frozen blastocysts, the first vaginal oocyte retrieval (VOR) taking place 12 weeks following hysterectomy. She experienced VCD during her second VOR that occurred 17 weeks after TLH, the second case of VCD to be reported in the literature during fertility preservation treatment following hysterectomy. The patient underwent an emergent and uncomplicated repair of the defect vaginally the same day. Conclusions Currently there are no guidelines in place for women who have undergone hysterectomy with regard to when they can begin fertility treatment in the post-operative period. Based on now two case reports, it is worth considering extension of the typical 6-week timeline of avoidance of vaginal procedures to allow for full cuff healing. Infertility providers should also be mindful of limiting transvaginal ultrasounds where possible to reduce force along the cuff. |
| Databáze: | OpenAIRE |
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