Department of Obstetrics and Gynecology, University of Gondar, Gondar, Ethiopia.
J Med Case Rep. 2020 Nov 24;14(1):227. doi: 10.1186/s13256-020-02552-0.
Genitourinary tract trauma caused by ox horn injury in the presence of pelvic organ prolapse (POP) is an extremely rare phenomenon and associated with devastating morbidity.
A 50-year-old multiparous postmenopausal woman from rural northwest Ethiopia presented with the primary complaint of urinary incontinence 6 days after she suffered ox horn injury to her prolapsed genitalia. She had stage 3 pelvic organ prolapse with the leading point being the cervix. The anterior vaginal and posterior bladder walls were disrupted with visible draining of the left ureter. The wound was dirty and edematous with whitish discharge. She was admitted to the urogynecology ward and provided with wound care until the infection subsided. Apical prolapse suspension was performed using right sacrospinous fixation, and bladder repair was carried out 6 weeks following the prolapse suspension. She recovered well and was continent when discharged.
Ox horn injury involving the female lower urogenital tract in the presence of POP is extremely rare. Late presentation after sustaining injury is associated with increased risk of morbidity and long hospital stay, and treatment requires multistage surgery.
生殖道创伤由牛角损伤引起,同时合并盆腔器官脱垂(POP),是一种极其罕见的现象,且与严重的发病率相关。
一位 50 岁的埃塞俄比亚农村多产妇绝经后妇女,因脱垂的生殖器官被牛角损伤后 6 天就诊,主要诉尿失禁。她患有 3 期盆腔器官脱垂,以宫颈为突出点。阴道前壁和膀胱后壁破裂,可见左侧输尿管漏尿。伤口污秽水肿,有白色分泌物。她被收入妇科病房,接受伤口护理,直到感染消退。采用右骶棘固定进行顶部脱垂悬吊,脱垂悬吊后 6 周进行膀胱修复。她恢复良好,出院时无尿失禁。
POP 合并女性下尿路生殖道牛角损伤极其罕见。受伤后晚期就诊与发病率增加和住院时间延长相关,治疗需要多阶段手术。