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Obstetrics & Gynecology 2004;103:572-576
© 2004 by The American College of Obstetricians and Gynecologists
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ORIGINAL RESEARCH

Characteristics of Patients With Vaginal Rupture and Evisceration

Andrew J. Croak, DO, John B. Gebhart, MD, Christopher J. Klingele, MD, Georgene Schroeder, Raymond A. Lee, MD and Karl C. Podratz, MD, PhD

From the Section of Gynecologic Surgery, and the Division of Biostatistics, Mayo Clinic, Rochester, Minnesota.

Address reprint requests to: John B. Gebhart, MD, Section of Gynecologic Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905; e-mail: gebhart.john{at}mayo.edu.

OBJECTIVE: To characterize vaginal rupture and evisceration.

METHODS: We reviewed medical records (1970–2001) for use of the diagnostic terms "vaginal rupture," "vaginal evisceration," and "ruptured enterocele."

RESULTS: Twelve clinical cases were identified. Patients usually presented with pain, vaginal bleeding, and abdominal pressure. In 9 of 12 women, rupture was primarily associated with postmenopausal prolapse and a history of pelvic surgery. Women with a history of abdominal hysterectomy tended to rupture through the vaginal cuff, and those with a history of vaginal hysterectomy tended to rupture through a posterior enterocele. Premenopausal rupture in 1 woman occurred postcoitally and involved the posterior fornix. Prolapse recurrence after repair was limited to 1 woman.

CONCLUSIONS: Vaginal rupture and evisceration should be considered in women presenting with acute vaginal bleeding and pelvic pain. Evaluation is especially important in postmenopausal women with a history of pelvic surgery. In some cases, surveillance after pelvic surgery may prevent rupture, evisceration, and incarceration.

LEVEL OF EVIDENCE: II-3






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