PELVIC ORGAN PROLAPSE AND INGUINAL HERNIA AGGRAVATED BY OVARIAN FIBROTHECOMA WITH ASCITES

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  • Matsuyama Aika
    Department of Urology, Japanese Red Cross Nagoya First Hospital
  • Kato Kumiko
    Department of Female Urology, Japanese Red Cross Nagoya First Hospital
  • Suzuki Shoji
    Department of Female Urology, Japanese Red Cross Nagoya First Hospital
  • Nishiko Yuki
    Department of Obstetrics and Gynecology, Japanese Red Cross Nagoya First Hospital
  • Sai Hiroki
    Department of Urology, Japanese Red Cross Nagoya First Hospital
  • Ishiyama Akinobu
    Department of Urology, Japanese Red Cross Nagoya First Hospital
  • Kato Takashi
    Department of Urology, Japanese Red Cross Nagoya First Hospital
  • Inoue Satoshi
    Department of Urology, Japanese Red Cross Nagoya First Hospital
  • Hirabayashi Hiroki
    Department of Urology, Japanese Red Cross Nagoya First Hospital
  • Hattori Ryohei
    Department of Urology, Japanese Red Cross Nagoya First Hospital

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  • 腹水を伴う卵巣莢膜細胞腫を背景に悪化した骨盤臓器脱と鼠径ヘルニアの1例

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Abstract

<p>We present a case of pelvic organ prolapse and inguinal hernia worsened by a benign ovarian tumor with ascites. A 61-year-old woman was referred to us complaining of feeling of something protruding from her vagina. She was diagnosed with Stage III cystocele. Behavioral therapy was administered as she had only slight subjective symptoms. She visited us eight months later due to a rapid aggravation of cystocele and voiding difficulty. She subsequently developed acute abdominal pain caused by incarcerated inguinal hernia. Abdominal ultrasound, MRI and CT showed a 10.6×9.0 cm pelvic mass with ascites. As an ovarian cancer with peritoneal dissemination was suspected, she immediately underwent total abdominal hysterectomy, bilateral salpingo-oophorectomy and colposuspension. Pathological diagnosis was fibrothecoma, a benign ovarian tumor. Postoperative course was uneventful, and ascites quickly disappeared in a manner similar to Meigs syndrome. Although no procedure was done to manage inguinal hernia, it was unproblematic for 18 months, after that it worsened, necessitating hernial repair. She had no recurrence of prolapse or ascites.</p><p>Increased intra-abdominal pressure due to abdominal mass or ascites can worsen prolapse and hernial diseases such as inguinal, umbilical, and abdominal hernia. In this case, ovarian fibrothecoma with ascites seemed to be responsible for worsening of the prolapse and inguinal hernia. To conclude, it is important to consider background diseases when examining patients with prolapse and coexisting hernial diseases.</p>

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