Case Report of a Successful Delivery in a 29-Year-Old Female with History of Purandare Hysteropexy Surgery

I. Gede Mega Putra; Riza Firman Satria; I. Wayan Megadhana; Kadek Fajar Marta; Ketut Surya Negara

doi:10.3889/oamjms.2020.3453

Authors

I. Gede Mega Putra Department of Obstetrics and Gynecology, Medical Faculty, Udayana University, Sanglah Hospital, Bali, Indonesia
Riza Firman Satria Department of Obstetrics and Gynecology, Medical Faculty, Udayana University, Sanglah Hospital, Bali, Indonesia
I. Wayan Megadhana Department of Obstetrics and Gynecology, Medical Faculty, Udayana University, Sanglah Hospital, Bali, Indonesia
Kadek Fajar Marta Department of Obstetrics and Gynecology, Medical Faculty, Udayana University, Sanglah Hospital, Bali, Indonesia
Ketut Surya Negara Department of Obstetrics and Gynecology, Medical Faculty, Udayana University, Sanglah Hospital, Bali, Indonesia http://orcid.org/0000-0003-4461-8374

DOI:

https://doi.org/10.3889/oamjms.2020.3453

Keywords:

Purandare hysteropexy surgery, Fascia sheath, Cesarean section surgery

Abstract

BACKGROUND: Pelvic organ prolapse (POP) generally does not contribute to mortality but can worsen the quality of life, because it can cause abnormal bladder, gastrointestinal system, and sexual function disorders which indirectly cause psychosocial stress and emotional disorders such as depression, isolation, and anxiety. The main purpose of surgical action in young women with POP is to reduce complaints such as fecal and urinary incontinence and also sexual disorders, restore normal anatomy structures, prevent recurrence POP, and maintain the ability of pregnancy, labor, and normal menstrual function. Purandare hysteropexy surgery is one of the conservative surgical procedures for POP in productive women with few operative complication, shorter operating time, and minimal bleeding. At present, there is no literature of pregnant women with the mode of delivery that is effective in patients with history of purandare hysteropexy surgery. This case aims to report delivery in patient with a history of purandare hysteropexy surgery. Pregnancy can be maintained up to gestational term age, healthy baby, and no adhesion during surgery.

CASE REPORT: A 29-year-old woman in full-term gestational age of her second pregnancy with a history of purandare hysteropexy surgery 1 year ago. During antenatal care patient, an evaluation of fascia sheath with ultrasonography was performed. The method of delivery was through cesarean section. During surgery, there was no intra-abdominal adhesion, the fascia sheath is well-maintained, and lower segment of uterine is covered by anterior fascia sheath. The operation outcome was a healthy baby boy, weighted 2900 g, body length 49 cm with good Apgar score.

CONCLUSION: Purandare hysteropexy surgery is one of the conservative surgical management for conservative treatment of uterovaginal prolapse in women of reproductive age group who wish to retain their capacity for childbearing. Pregnancy up to term gestational age, during cesarean section, surgery seen no intra-abdominal adhesion, all sides of fascia sheath are well-maintained and the outcome was a baby with healthy condition.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

Plum Analytics Artifact Widget Block

References

Strohbehn K, Jakary JA, Delancey JO. Pelvic organ prolapse in young women. Obstetr Gynecol. 1997;90(1):33-6. https://doi.org/10.1016/s0029-7844(97)00218-4 PMid:9207808 DOI: https://doi.org/10.1016/S0029-7844(97)00218-4

Jelovsek JE, Maher C, Barber MD. Pelvic organ prolapse. Lancet. 2007;369(9566):1027-38. PMid:17382829

Lince LS, van Kempen LC, Vierhout ME, Kluivers KB. A systematic review of clinical studies on hereditary factors in pelvic organ prolapse. Int Urogynecol J. 2012;23(10):1327-36. https://doi.org/10.1007/s00192-012-1704-4 PMid:22422218 DOI: https://doi.org/10.1007/s00192-012-1704-4

Alcalay M, Stav K, Eisenberg VH. Family history associated with pelvic organ prolapse in young women. Int Urogynecol J. 2015;26(12):1773-6. PMid:26174658 DOI: https://doi.org/10.1007/s00192-015-2779-5

Kim S, Harvey MA, Johnston S. A review of the epidemiologi and pathofisiology of pelvic floor dysfunction: Do racial differences matter? J Obstet Gynaecol Can. 2005;27(3):251-9. PMid:15937599 DOI: https://doi.org/10.1016/S1701-2163(16)30518-7

Guldberg R. Clinical epidemiological studies of women undergoing surgery for urogynaecological disorders. Dan Med J. 2015;62(10):B5154. PMid:26441398

Cilgin H. Laparoscopic Uterine Conservation in Uterovaginal Prolapse. United States: Advanced Laparoscopy; 2017.

Putra IG, Kawilarang S. Purandare histeropexy technique in a 28 year old female with pelvic organ prolapse stage III: A rare case report. Bali Med J (Bali Med). 2016;5(3):385-7. https://doi.org/10.15562/bmj.v5i2.256 DOI: https://doi.org/10.15562/bmj.v5i2.256

Rameshkumar R, Kamat L, Tungal S, Moni S. Modified Purandare’s cervicopexy-a conservative surgery for genital prolapse: A retrospective study. Int J Reprod Contracept Obstet Gynecol. 2017;6(5):1777-81. https://doi.org/10.18203/2320-1770.ijrcog20171529 DOI: https://doi.org/10.18203/2320-1770.ijrcog20171529

Nagrath A, Malhotra N. Uterus Displacement: A Colour Atlas of Cervicopexy Purandares (Single Surgical Procedures in Obstetrtrics and Gynaecology). Tamil Nadu: Jaypee Brothers Medical Pub; 2012. p. 2-3. https://doi.org/10.5005/jp/books/11506_5 DOI: https://doi.org/10.5005/jp/books/11506_5