Cystocele management in multisurgical patients: a comprehensive case report emphasizing advanced diagnostic and surgical precision

Prajakta Bhimgade; Chandana P. Tholu; Shalini Dange; Amruta A. Choudhary; Anita Yadav; Shuchita Mundle

doi:10.18203/2320-1770.ijrcog20242090

Authors

Prajakta Bhimgade Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, Nagpur, Maharashtra, India
Chandana P. Tholu Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, Nagpur, Maharashtra, India
Shalini Dange Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, Nagpur, Maharashtra, India
Amruta A. Choudhary Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, Nagpur, Maharashtra, India
Anita Yadav Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, Nagpur, Maharashtra, India
Shuchita Mundle Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, Nagpur, Maharashtra, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20242090

Keywords:

Cystocele, Caesarean sections, Diabetes mellitus, Multidisciplinary collaboration, Pelvic organ prolapse, Surgical planning

Abstract

Pelvic organ prolapses (POP), particularly cystocele, presents significant challenges in postmenopausal women, exacerbated in those with multiple caesarean sections (LSCS) and comorbidities like diabetes mellitus. This case report details the successful management of a 62-year-old woman with a large cystocele, three LSCS, and diabetes mellitus. Thorough preoperative evaluation, including ultrasound and diagnostic laparoscopy, guided surgical planning. Anterior colporrhaphy restored support to the anterior vaginal wall. Perioperative care included strict glycemic control and antibiotic prophylaxis. Multidisciplinary collaboration ensured comprehensive management. This case highlights the importance of advanced diagnostics, meticulous surgical planning, and multidisciplinary care in complex cystocele cases.

Metrics

Metrics Loading ...

References

Romero R, Kalache KD, Kada N. Timing the delivery of the preterm severely growth restricted fetus: venous Doppler, cardiotocography on the biophysical profile? Ultrasound Obstet Gynacol. 2002;19:118-21.

Giles WB, Trudringer BJ, Baird PJ. Fetal Umbilical flow velocity wave form and placental resistance pathological co-relation. Br J Obstet Gynacol. 1985;92:31-8.

Mendez MA, Gayta MV, Flores R. Doppler ultrasound evaluation in preeclampsia. BMC Res Notes. 2013;19:477.

Gramellini D, Folli MC, Raboni S, Vadora E, Merialdi A. Cerebral-umbilical Doppler ratio as a predictor of adverse perinatal outcome. Obstet Gynecol. 1992;79(3):416-20.

Bano S, Chaudhary V, Pande S, Mehta VC, Sharma AK. Colour Doppler evaluation of cerebral umbilical pubatility ratio and its usefulness in the diagnosis of intrauterine growth restriction and prediction of adverse perinatal outcome. Indian J Radiol Imaging. 2010;20(1):20-5.

Mari G, Hanif F, Kruger M, Cosmi E, Forgas SJ, Treadwell MC. Middle cerebral artery peak systolic velocity a new Doppler parameter in the assessment of growth restricted fetus. Ultrasound Obstet Gynacol. 2007;29(3):310-6.

Schenone MH, Mari G. The MCA Doppler and its role in the evaluation of fetal anemia and fetal growth restriction. Clin Perinatal. 2011;38(1):83-102.

Hecher K, Campbell S, Doyle P, Harrington K, Nicoladies K. Asessment of fetal compromise by Doppler ultrasound investigation of the fetal circulation. Circulation. 1995;91:129-38.

Baschat AA, Gembruch U, Weiner CP, Harman CR. Qualitative venous Doppler waveforms analysis improves prediction of critical perinatal outcome in premature growth restricted foetuses. Ultrasound Obstet Gynacol. 2003;22:240-5.

Brown MA, Lindheimer MD, Swiet M, Assche VA, Moutquin JM. The classification and diagnosis of the hypertensive disorders of pregnancy: statement from the international society for the study of hypertension in pregnancy (ISSHP). Hypertens Pregnancy. 2001;20:19-24.

Kurmanavicius J, Florio I, Wisser J, Hebisch G, Zimmermann R, Muller R et al. Refence resistance indices of the umbilical, fetal middle cerebral and uterine arteries at 24-42 weeks of gestation. Ultrasound Obstet Gynecol. 1997;10:112-20.

Ozeren M, Dinc H, Ekmen U, Senekayli C, Aydemir V. Umbilical and middle cerebral artery Doppler indices in patients with preeclampsia. Eur J Obstet Gynecol Reprod Biol. 1999;82:11-6.

Yoon BH, Lee CM, Kim SW. An abnormal umbilical artery waveform: A strong and independent predictor of adverse perinatal outcome in patients with preeclampsia. Am J Obs Gyn. 1994;171:713-21.