An unusual complication after vaginal hysterectomy

Area of Science:

• Urogynecology
• Geriatric surgery

Background:

• Uterovaginal prolapse is prevalent in older women, necessitating surgical intervention like vaginal hysterectomy for definitive treatment.
• Surgical repair often includes addressing pelvic floor defects and incontinence.

Observation:

• A 66-year-old postmenopausal woman underwent vaginal hysterectomy with anterior and posterior colporrhaphy and mid-urethral sling placement.
• She experienced an unexplained pubic ramus fracture during the perioperative period.

Findings:

• The patient developed a pubic ramus fracture, an unusual complication not attributable to surgical events or medical history.
• This suggests potential underlying factors or rare iatrogenic risks in this patient population.

Implications:

• Routine vaginal surgeries in older women, despite being common, carry risks of unexpected complications.
• Clinicians should maintain vigilance for rare adverse events even in standard procedures for pelvic organ prolapse.