Vaginal Evisceration Complicating Inguinal Hernia Repair

Risk factors for evisceration after abdominal or vaginal hysterectomy include: poor operative technique, postoperative infection, hematoma, coitus before healing, elder age, radiotherapy, corticosteroid therapy, trauma or rape, previous vaginoplasty, and elevated abdominal pressure.4 To the above we should add the existence of enterocele as a manifestation of pelvic floor weakness. The most frequently reported site of the defect is the posterior fornix; the weakest point of the vaginal vault commonly associated with a posterior enterocele.2 Subtotal hysterectomy with preservation of the cervix may have an advantage over total abdominal hysterectomy, as it causes less vaginal shortening and vault prolapse.