Ran Meng,1,2,* Zheng Fang,2,* Jing Fu,2,3 Qiaoyun Cai,2,3 Yingli Shen,2,3 Yuru Hu,2,3 Rongyao Li,2,3 Cheng Peng1,2 

1Graduate School of Anhui Medical University, Hefei, Anhui, 23000, People’s Republic of China; 2Department of Obstetrics and Gynecology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, 230001, People’s Republic of China; 3Graduate School of Bengbu Medical University, Bengbu, Anhui, 233000, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Cheng Peng, The First Affiliated Hospital of USTC, Graduate School of Anhui Medical University, Hefei, Anhui, 230000, People’s Republic of China, Email slyypc@163.com

Objective: Vaginal cuff rupture is a rare but serious postoperative complication predominantly occurring after hysterectomy. Given that it can lead to partial or total evisceration, bowel strangulation, sepsis, and acute mesenteric ischemia. Any instance of this complication should be treated as a surgical emergency. In this context, we report a case of a vaginal stump following regular use of pessaries.
Case Report: A 50-year-old woman was admitted to the hospital with sudden onset of bowel-like prolapse from the vagina. She had a 7-year history of vaginal prolapse and had previously undergone repair surgery and laparoscopic hysterectomy for uterine fibroids. Following her hysterectomy, she began using a pessary due to recurrent prolapse. Clinical assessment revealed vaginal evisceration of the intestines, necessitating emergency surgery. She was discharged smoothly on the eighth day post-operation. Three months later, she underwent a laparoscopic sacrocolpopexy.
Conclusion: The utilization of pessaries may heighten the risk of stump rupture in patients following hysterectomy, thereby demanding more vigilant attention from gynecologists.

Keywords: pessary complications, vaginal evisceration, sacrocolpopexy