Spontaneous Healing of Vaginal Cuff Dehiscence in a Uterine Cervical Cancer Following Laparoscopic Radical Hysterectomy and Chemoradiation

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Journal of Gynecologic Surgery


Vaginal cuff dehiscence (VCD) after hysterectomy has a low incidence but has serious sequelae. Given that there is no consensus about the ideal management of VCD, it depends on the patient's condition, including that of the patient's eviscerated organ. Surgical repairs are performed in most cases. Case: VCD occurred in a 51-year-old patient with uterine cervical cancer following a laparoscopic radical hysterectomy and chemoradiation. It was decided to wait for spontaneous vaginal closure and to reassess the condition of this patient's vagina every 3 months. Results: Three months after this patient's VCD diagnosis, her vaginal opening became smaller and was already covered by a thin membrane. This membrane gradually became thicker and the vaginal opening was completely closed after 2 years. Conclusions: Radiation therapy may impair wound healing and affect surgical outcomes of treating VCD. It may take time to heal the wound completely following radiation therapy. However, in cases with fibrotic vaginal mucosa post radiation therapy or in patients who have undergone previous multiple surgeries wherein another surgery—either vaginal or abdominal—would be risky, nonclosure can be another option for approaching VCD.

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