Laparoscopic hysterectomy with intraoperative treatment of vaginal strictures: A case report

TL;DR

A successful laparoscopic hysterectomy was performed alongside vaginal stricture dilation in a patient with suspected endometriosis.

Contribution

This is the first reported case combining laparoscopic hysterectomy with intraoperative vaginal stricture dilation.

Findings

Concurrent dilation and hysterectomy were performed without complications.

Postoperative vaginal estrogen maintained patency in a non-sexually active patient.

Pathology confirmed endometriosis and benign ovarian cystadenofibromas.

Abstract

There is limited data regarding management of vaginal strictures with a concurrent hysterectomy, in all realms, including pre-, intra- and postoperative care. A 44-year-old nulligravid woman with multiple vaginal strictures and clinically suspected endometriosis was evaluated preoperatively and underwent laparoscopic hysterectomy with simultaneous dilation of vaginal strictures without complication. Postoperative care included vaginal estrogens and vaginal dilators. Concurrent vaginal stricture dilation and laparoscopic hysterectomy can be successful and without complication with the use of intraoperative dilation and postoperative estrogens.

•seemingly the first case of concurrent laparoscopic hysterectomy and intraoperative vaginal stricture dilation in a patient with multiple strictures and suspected endometriosis.•Adaptive surgical techniques enabled successful hysterectomy despite the cervix inaccessability.•Postoperative vaginal estrogen maintained structure patency in a non-sexually active patient.•Pathology correlation confirmed endometriosis and benign ovarian cystadenofibromas, supporting clinical diagnosis.•Demonstrates a feasible approach for complex cases, though long-term outcomes require further study.

seemingly the first case of concurrent laparoscopic hysterectomy and intraoperative vaginal stricture dilation in a patient with multiple strictures and suspected endometriosis.

Adaptive surgical techniques enabled successful hysterectomy despite the cervix inaccessability.

Postoperative vaginal estrogen maintained structure patency in a non-sexually active patient.

Pathology correlation confirmed endometriosis and benign ovarian cystadenofibromas, supporting clinical diagnosis.

Demonstrates a feasible approach for complex cases, though long-term outcomes require further study.

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