Single-incision vaginal mesh insertion for recurrent vaginal vault prolapse after radical cystectomy and radical hysterectomy with irradiation: A case report

Abstract

A 74-year-old female patient five month after radical robot assisted cystectomy (RC) with ileal conduit (IC) presented to our department with stage 4 symptomatic vaginal prolapse and anterior enterocele (AE). In the medical history 43 years ago radical hysterectomy (Piver 3) was revealed followed by postoperative irradiation and brachytherapy, due to invasive cervical cancer. A total colpocleisis was carried out as a first line therapy. A recurrence occurred 8 months after the first surgery. We used a customized single-incision vaginal mesh for the relapse operation. The patient has been symptomless for 50 months. We believe that vaginal irradiation is a rare but significant risk factor for the development of anterior enterocele after RC with IC and single-incision tailored vaginal mesh insertion for symptomatic anterior enterocele after radical cystectomy and radical hysterectomy with irradiation may be a long-term surgical solution.