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Ginecología y obstetricia de México
versão impressa ISSN 0300-9041
Resumo
LOPEZ-TALAVERA, Violeta et al. Uretroplaty and anal sphincteroplasty after to obstetric trauma. Ginecol. obstet. Méx. [online]. 2022, vol.90, n.2, pp.174-179. Epub 30-Maio-2022. ISSN 0300-9041. https://doi.org/10.24245/gom.v90i2.5396.
BACKGROUND:
Childbirth is an important risk factor for pelvic floor trauma and dysfunction. Perineal injuries are of the order of 6% and anterior vaginal tears, with urethral injury, account for 5.5%.
OBJECTIVE:
To report the surgical procedure of a patient with pelvic floor dysfunction secondary to tears in the birth canal.
CLINICAL CASE:
25-year-old patient who presented for consultation due to pelvic pain, continuous urinary and fecal incontinence with a history of laceration of the right wall of the vagina and urethra with a transpartum III C perineal tear. Diagnostic studies of cystoscopy and retrograde cystourethrography showed a severe perineal tear together with urethral trauma. With previous knowledge, surgical intervention was decided to perform: vaginoplasty, reconstructive urethroplasty, closure of the ischiorectal fossa with perineoplasty and anal sphincteroplasty. Even with the above, the patient continued with stress urinary incontinence, for which reason a retropubic midurethral tape was placed four months later. At 12 months follow-up she remained with urinary and fecal continence, remission of pelvic pain and no dyspareunia.
CONCLUSIONS:
Pelvic floor disorders should be evaluated by trained medical personnel for indicated intervention.
Palavras-chave : Childbirth; Trauma; Perineal injuries; Vaginal tears; Urethral injuries; Cystoscopy; Retrograde cystourethrography.