Khaleel Mansour, Ayyad Mohammed, Albandak Maram, C N Khalil Nabil, M A Abu Taleb Sari
Internal Medicine, Al-Makassed Charitable Society Hospital, Jerusalem, PSE.
Internal Medicine, Al-Quds University, Jerusalem, PSE.
Cureus. 2023 Sep 1;15(9):e44513. doi: 10.7759/cureus.44513. eCollection 2023 Sep.
Pelvic organ prolapse (POP) is a common condition mainly affecting postmenopausal women, characterized by the descent of pelvic organs through the vaginal canal. While often asymptomatic, POP can manifest with various symptoms such as a painless bulge or pressure sensation, abdominal pain, urinary complaints, and discomfort during intercourse. Severe cases can lead to urinary tract obstruction, hydronephrosis, and renal dysfunction. This case study presents an elderly female with bilateral severe hydronephrosis and pyelonephritis due to undiagnosed POP. Imaging revealed obstructive uropathy resulting from bilateral ureteric compression caused by cystocele and uterine prolapse. The patient's condition improved with antibiotics and supportive management. A vaginal hysterectomy was performed, which led to the resolution of the urinary tract obstruction. This case emphasizes the importance of considering POP in elderly women with urinary symptoms and the need for proactive screening. It highlights the significance of appropriate management to prevent irreversible renal damage. Different treatment modalities, including surgery and pessaries, are discussed, to emphasize the significance of tailoring treatments to individual patient characteristics.
盆腔器官脱垂（POP）是一种主要影响绝经后女性的常见病症，其特征是盆腔器官通过阴道管下降。虽然通常无症状，但POP可表现为各种症状，如无痛性肿块或压迫感、腹痛、泌尿系统症状以及性交时不适。严重病例可导致尿路梗阻、肾积水和肾功能障碍。本病例研究介绍了一名老年女性，因未确诊的POP导致双侧严重肾积水和肾盂肾炎。影像学检查显示，膀胱膨出和子宫脱垂导致双侧输尿管受压，从而引起梗阻性尿路病。患者经抗生素治疗和支持性管理后病情好转。随后进行了阴道子宫切除术，尿路梗阻得以解除。该病例强调了在有泌尿系统症状的老年女性中考虑POP的重要性以及积极筛查的必要性。它突出了适当管理以预防不可逆转的肾损伤的重要性。文中讨论了包括手术和子宫托在内的不同治疗方式，以强调根据个体患者特征定制治疗方案的重要性。
