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Complete procidentia: temporizing treatment with an obstetric balloon
Reesha Sanghani1, N Trent Rice, Carl W Zimmerman
1Department of Obstetrics and Gynecology, Vanderbilt University School of Medicine, Nashville, Tennessee.
Background:
Pelvic organ incarceration resulting from complete uterovaginal prolapse is rare. Unique management and treatment of this condition are presented.
Case:
A 66-year-old multigravid woman presented with increasing abdominal pain, 1-day history of urinary retention, and 30-day history of obstipation. She exhibited complete procidentia, and an attempt to reduce the prolapse immediately was unsuccessful. After fecal disimpaction in the operating room, an obstetric balloon was used for temporary reduction.
Conclusion:
Incarcerated complete procidentia is treated in a stepwise process, initially reducing the prolapse to relieve acute incarceration symptoms. Typically, reduction is accomplished with the aid of a pessary. However, because of this patient's condition, an obstetric balloon was used for temporary reduction to allow subsequent surgical treatment after tissue rest and medical stabilization. This method should be considered in similar situations.
