Application of single-incision transvaginal mesh in a woman undergoing peritoneal dialysis and suffering from refractory advanced stage pelvic organ prolapse.

OBJECTIVE

We would like to provide an option of minimal invasive surgical intervention for a patient with end-stage renal disease undergoing continuous ambulatory peritoneal dialysis, who was at the advanced-stage pelvic organ prolapse (POP) and who also failed to be treated conservatively.

MATERIALS AND METHOD

We present a case of uterine prolapse stage IV in a woman who underwent continuous ambulatory peritoneal dialysis due to end-stage renal disease. Her severity of POP had only limited improvement after being switched to hemodialysis and vaginal cream use. After her informed consent, we performed a uterus-sparing transvaginal mesh procedure to adjust the anterior, apical, and posterior defects of pelvis.

RESULTS

There has been no recurrence of any compartment of POP during the 16-month follow-up period, nor any mesh-related complications. The perineal swelling subsided after switching to nocturnal automated peritoneal dialysis only in the supine position.

CONCLUSION

Patients with POP at an advanced stage during peritoneal dialysis who failed to be treated conservatively may require a surgical intervention. Uterus-sparing transvaginal mesh was a feasible minimal invasive option.