Incidental Finding of Asymptomatic Vaginal Cuff Dehiscence with Evisceration of Abdominal Content During Prolapse Repair

Background: Vaginal cuff dehiscence with abdominal content evisceration is typically a surgical emergency. Case: A 45-year-old woman with a history of vaginal hysterectomy, anterior/posterior repair, and needle bladder-neck suspension 2 years prior presented with new-onset seepage of fluid from the suprapubic incision and recurrent pelvic organ prolapse (POP). A staged approach was planned: included surgical exploration of the suprapubic incision, and then repair of the recurrent POP. An intact vaginal cuff had been confirmed during the initial surgery and postoperative examination. However, vaginal cuff dehiscence with evisceration of colonic epiploica was discovered incidentally during the planned prolapse repair. Results: This patient underwent repair of the dehiscence with planned robotic-assisted laparoscopic sacrocolpopexy and recovered without known complications. Conclusions: This is a rare instance of nonemergent, asymptomatic chronic vaginal cuff dehiscence with evisceration of abdominal contents.