Vaginal cuff dehiscence following transvaginal oocyte retrieval: a case report

Area of Science:

• Reproductive medicine
• Gynecologic surgery
• Oncology

Background:

• Vaginal cuff dehiscence (VCD) is a rare complication post-hysterectomy, with an incidence of 0.14-1.4%.
• Risk factors for VCD are not fully understood due to its rarity.
• Increasing numbers of women with reproductive tract cancers are pursuing fertility preservation.

Observation:

• A 35-year-old patient developed VCD during her second transvaginal oocyte retrieval (VOR) 17 weeks after a total laparoscopic hysterectomy (TLH).
• This is the second reported case of VCD during fertility treatment post-hysterectomy.
• The patient underwent successful emergent vaginal repair.

Findings:

• The case highlights a potential emerging clinical scenario in fertility preservation.
• Current guidelines lack specific timelines for initiating fertility treatments post-hysterectomy.

Implications:

• Consider extending the typical 6-week waiting period post-hysterectomy before vaginal procedures for fertility treatment.
• Infertility providers should minimize transvaginal ultrasounds to reduce stress on the vaginal cuff.