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Complete Erosion of Abdominal Cerclage Into the Bladder

Published:April 16, 2021DOI:https://doi.org/10.1016/j.jogc.2021.03.017

      ABSTRACT

      Background

      Abdominal cerclage is indicated for some women with cervical insufficiency. Long-term complications from cerclage are rare.

      Case

      Here we report the case of a patient who presented with recurrent urinary tract infection and hematuria 5 years after laparoscopic abdominal cerclage. Cystoscopy revealed bladder stones surrounding a foreign body. Another cystoscopy 3 months later showed complete erosion of the cerclage into the bladder.

      Conclusion

      This case reminds us that differential diagnosis of urinary symptoms in women who have undergone cervical cerclage should include suture erosion into the bladder. Cerclage removal can be offered to women who have completed childbearing to prevent this rare complication.

      RÉSUMÉ

      Contexte

      Le cerclage abdominal est indiqué chez certaines femmes atteintes d'incompétence du col. Les complications à long terme du cerclage sont rares.

      Cas

      Nous présentons ici le cas d'une patiente atteinte d'une infection urinaire récidivante et d'hématurie 5 ans après un cerclage abdominal laparoscopique. La cystoscopie a révélé la présence de calculs vésicaux autour d'un corps étranger. Une autre cystoscopie effectuée 3 mois plus tard a révélé une érosion complète du cerclage dans la vessie.

      Conclusion

      Ce cas nous rappelle que le diagnostic différentiel des symptômes urinaires chez les femmes qui ont subi un cerclage du col doit comprendre l’érosion de sutures dans la vessie. Il est possible d'offrir le retrait du cerclage aux femmes n'ayant plus de désir de grossesse afin de prévenir cette rare complication.

      Keywords

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      References

        • Tulandi T
        • Alghanaim N
        • Hakeem G
        • et al.
        Pre and post-conceptional abdominal cerclage by laparoscopy or laparotomy.
        J Min Invasive Gynecol. 2014; 21: 987-993
        • Al-Fadhli R
        • Tulandi T
        Laparoscopic abdominal cerclage.
        in: Donnez J Atlas of laparoscopy and hysteroscopy. Informa Healthcare, Abingdon2007: 403-406
        • Alfirevic Z
        • Stampalija T
        • Medley N
        Cervical stitch (cerclage) for preventing preterm birth in singleton pregnancy.
        Cochrane Database Syst Rev. 2017; 6CD008991
        • Moawad G
        • Tyan P
        • Bracke T
        • et al.
        Systematic review of transabdominal cerclage placed via laparoscopy for the prevention of preterm birth.
        J Minim Invasive Gynecol. 2018; 25: 277-286
        • Deffieux X
        • de Tayrac R
        • Louafi N
        • et al.
        Technique de cerclage cervico-isthmique par voie vaginale avec bandelette de polypropylène: technique de Fernandez [Transvaginal cervico-isthmic cerclage using polypropylene tape: surgical procedure and pregnancy outcome: Fernandez's procedure].
        Gynecol Obstet Biol Reprod (Paris). 2006; 35 ([in French]): 465-471
        • Whittle WL
        • Singh SS
        • Allen L
        • et al.
        Laparoscopic cervico-isthmic cerclage: surgical technique and obstetric outcomes.
        Am J Obstet Gynecol. 2009; 201 (364.e1–7)
        • Massengill JC
        • Baker TM
        • Von Pechmann WS
        • et al.
        Commonalities of cerclage-related genitourinary fistulas.
        Female Pelvic Med Reconstr Surg. 2012; 18: 362-365
        • Ruan JM
        • Adams SR
        • Carpinito G
        • et al.
        Bladder calculus presenting as recurrent urinary tract infections: a late complication of cervical cerclage placement: a case report.
        J Reprod Med. 2011; 56: 172-174
        • Wall LL
        • Khan F
        • Adams S
        Vesicovaginal fistula formation after cervical cerclage mimicking premature rupture of membranes.
        Obstet Gynecol. 2007; 109: 493-494
        • Hawkins E
        • Nimaroff M
        Vaginal erosion of an abdominal cerclage 7 years after laparoscopic placement.
        Obstet Gynecol. 2014; 123: 420-423