Migration of a Hodge pessary into the abdominal cavity; a rare complications

A 62‐year old para 4 with a history of a radical hysterectomy followed by radiotherapy for endometrial carcinoma was seen shortly after insertion of a pessary for a total vault prolapse. On follow‐up the pessary couldn't be retrieved. An abdominal X‐ray revealed the pessary in the abdominal cavity and it had to be removed by means of a laparotomy. Fistula and defects have been reported both in longstanding pessary use and as long‐term complication in radical surgery with radiotherapy. In view of potential – though rare – serious complications, adequate follow‐up in pessary use is therefore mandatory. Adequate diagnostic investigations are essential in deciding on an appropriate approach for rare cases like these.