Postcoital Vaginal Perforation and Evisceration in Women with No Prior Pelvic Surgery: Laparoscopic Management and Systematic Review of the Literature

Guglielmo Stabile, Denise Mordeglia, Federico Romano, Stefania Carlucci, Francesco Paolo Mangino, Luigi Nappi, Felice Sorrentino, Nicolò De Manzini and Giuseppe Ricci
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Guglielmo Stabile: Institute for Maternal and Child Health, IRCCS Burlo Garofolo, 34100 Trieste, Italy
Denise Mordeglia: Department of Medicine, Surgery and Health Sciences, University of Trieste, 34127 Trieste, Italy
Federico Romano: Institute for Maternal and Child Health, IRCCS Burlo Garofolo, 34100 Trieste, Italy
Stefania Carlucci: Department of Obstetrics and Gynecology, Azienda Sanitaria Universitaria Giuliano-Isontina, San Polo Hospital, Gorizia-Mofalcone, 34127 Trieste, Italy
Francesco Paolo Mangino: Institute for Maternal and Child Health, IRCCS Burlo Garofolo, 34100 Trieste, Italy
Luigi Nappi: Department of Medical and Surgical Sciences, Institute of Obstetrics and Gynecology, University of Foggia, 71122 Foggia, Italy
Felice Sorrentino: Department of Medical and Surgical Sciences, Institute of Obstetrics and Gynecology, University of Foggia, 71122 Foggia, Italy
Nicolò De Manzini: Department of Medicine, Surgery and Health Sciences, University of Trieste, 34127 Trieste, Italy
Giuseppe Ricci: Institute for Maternal and Child Health, IRCCS Burlo Garofolo, 34100 Trieste, Italy

IJERPH, 2021, vol. 18, issue 18, 1-12

Abstract: Objective: to evaluate risk factors, causes, management and surgical therapy of postcoital vaginal perforation and evisceration in women with no prior pelvic surgery. Data sources: We used MEDLINE (PubMed), Scopus, Embase and Web of Science for our research. Our review includes all reports from 1980 to November 2020. The research strategy adopted included different combinations of the following terms: (intercourse) AND (coitus) AND (vaginal perforation). Methods of study selection: we report a case of vaginal evisceration after consensual intercourse in a young and healthy woman. In addition, we performed a systematic review of vaginal perforations with or without evisceration in women without prior surgery or any other predisposing disease. All studies identified were listed by citation, title, authors and abstract. Duplicates were identified by an independent manual screening, performed by one researcher and then removed. For the eligibility process, two authors independently screened the title and abstracts of all non-duplicated papers and excluded those not pertinent to the topic. Tabulation, integration and results: We have followed the PRISMA guidelines. Five manuscripts were detected through the references of the works that had been identified with the research on MEDLINE (PubMed), Scopus, Embase and Web of Science. We found 16 cases between 1980 and 2020. The young age and the virginal status represent the principal risk factors and all the lacerations occurred in the posterior vaginal fornix. The most common surgical technique was the laparotomic approach and, in the remaining cases, the laparoscopic and vaginal route was performed. Conclusions: Post-coital vaginal perforation and evisceration in women with no prior pelvic surgery is a rare condition in the clinical practice and, when it is associated with evisceration it is a surgical emergency. Usually, these injuries are not life-threatening conditions but, a delay in diagnosis, can lead to severe complications. In consideration of the high heterogeneity of the data in the literature, it is essential to define a diagnostic–therapeutic management for the patients with vaginal perforation. With our review, we try to identify the associated risk factors, the best and fastest diagnosis, and the best surgical approach. We believe that a combined vaginal and laparoscopic approach can be the best surgical treatment, useful to diagnose injuries of the abdominal organs and to improve postoperative outcome.

Keywords: vaginal perforation; vaginal rupture; evisceration; postcoital; sexual intercourse; laparoscopy (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (2)

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