ĐIỀU TRỊ SA MỎM CẮT ÂM ĐẠO BẰNG PHƯƠNG PHÁP ĐẶT VÒNG NÂNG TRÊN CA LÂM SÀNG TẠI BỆNH VIỆN PHỤ SẢN THÀNH PHỐ CẦN THƠ

Abstract

Post-Hysterectomy Vaginal Vault Prolapse (PHVP) is the descent of the apex of the vagina (vaginal vault or cuff scar) after hysterectomy. PHVP is a rare complication following both abdominal and vaginal hysterectomy. The risk is increased in women following with vaginal hysterectomy. PHVP has been reported to follow 11.6% of hysterectomies performed for prolapse and 1.8% for other benign diseases [4]. Today, there are many methods to treat PHVP such as surgery, pelvic floor muscle training, vaginal pessary. In particular, surgical intervention remains integral in the effective management of women with post-hysterectomy vaginal vault prolapse. But for frail elderly patients, with many associated medical conditions, vaginal pessary remains a conservative treatment option that can be considered as first-line treatment. The success rate of pessary fitting was 63.2% [3]. It shows that the unsuccessfull rate of pessary fitting is very high. One of the factors that predict the likelihood of insertion failure is having a hysterectomy. However, we would like to discuss a case of successful treatment for vaginal cuff scar with a pessary, with the increase in quality of life. Patient 73 years old, PARA 100010, vaginal cuff scar prolapse stages III of POP-Q. The patient who was placed on the treatment pessary with PFDI-20 and PFIQ-7 scores before insertion of the Gellhorn pessary 57mm was 141.67 and 95.24. After 1 month of follow-up, the PFDI-20 and PFIQ-7 scores improved significantly with 27.08 and 14.29 scores.