RESUMEN
We have conducted this study to measure the outcome of vaginal sacrospinous colpopexy for the correction of vaginal vault and uterine prolapse regarding the success rate and safety. This is a descriptive study which was conducted at the Department of Obstetrics and Gynecology at King Hussein Medical Center during the period between March 2010 to September 2011. A total of 32 patients underwent vaginal sacrospinous fixation with preservation of the uterus, or combined with vaginal hysterectomy, vaginal repair and anti-incontinence procedure. The patients were re-evaluated after two weeks, two months and six months of the procedure. A specially designed medical record abstract form was used to collect the study data. Simple descriptive statistics [median, mean, frequency and percentage] were used to describe the study variables. The diagnosis of patients whom were operated included uterine prolpse in 23[72%] patients and vaginal vault prolapse in 9 [28%] patients. The operation was successful in 97% of the patients. During follow-up period, the operation was complicated with urinary tract infection in 3 [9%] patients and 2[6%] patients with low back pain. We had not encountered any intra-operative complications in relation to the procedure. The success rate for vaginal sacrospinous colpopexy operation was 97% in our series with minimal perioperative complications. It may be concluded that vaginal sacrospinous colpopexy may be safely combined with other vaginal surgeries for patients with uterovaginal prolapsed
RESUMEN
The use of an intrauterine contraceptive device is safe in most of cases, but it is not free of complications. One of the most dangerous complications is perforation of the uterine cavity by the intrauterine contraceptive device, and its migration to the abdominal cavity. The case which we report here is about a 27 year old woman who presented to the hospital complaining of lower abdominal pain. She had a history of intrauterine contraceptive device insertion six weeks following a caesarean section. Uterine perforation was suspected by the intrauterine contraceptive device, so the patient was referred to King Hussein Medical Centre for further evaluation and management. After full clinical examination, ultrasonographic and x-ray examination, the patient was diagnosed to have a missing device from the uterus. The patient underwent laparoscopy which failed to locate the intrauterine contraceptive device. Post-operatively the patient was advised to undergo laparatomy, but she refused and was lost to follow-up. After ten months the patient presented to the clinic complaining of pelvic cramps and the decision was taken to perform a laparatomy. Laparatomy was performed and revealed the intrauterine contraceptive device was impacted in the caecum; the surgeon opened the lumen and found the intrauterine contraceptive device within the wall of the caecum but not penetrating the lumen. The intrauterine contraceptive device was removed and the bowel was closed in two layers