Primary carcinoma of vagina with uterine prolapse

Eleven cases of primary carcinoma of vagina were admitted in Kasturba Medical College Hospital during the last 10 years, of which 6 cases aged 44-72 years, were associated with 3rd degree uterine prolapse. All the patients attended the hospital in late stage in spite of having 3rd degree uterine prolapse. Blood stained discharge and ulceration on the prolapsed part, irreducible prolapse with urinary retention and marked oedema of local and surrounding tissues were the presenting symptoms. Lesion on the vagina varied in size from 5 cm to 15 cm. IVP in both the cases of irreducible prolapse and retention of urine revealed hydroureter and hydronephrosis bilaterally. X-ray chest revealed secondaries in one patient only. Histopathology of vaginal biopsy revealed well differentiated squamous cell carcinoma in 5 cases and undifferentiated squamous cell carcinoma in one. Since the patients were in late stage of malignancy and were inoperable, treatment with external telecobalt therapy was undertaken. One patient developed vesicovaginal fistula during the treatment period and another patient developed it at the end of telecobalt therapy.