AUGS/IUGA Scientific Meeting 2019-Removal of an Incarcerated Vaginal Pessary

Removal of an Incarcerated Vaginal Pessary

Video Transcription

Video Summary

This video discusses the case of an 88-year-old woman with vaginal prolapse who had a Gellhorn pessary inserted to treat her condition. However, after five years, she presented with urinary incontinence, and it was discovered that the pessary was embedded high in the vaginal vault surrounded by granulation tissue and calcifications. Attempts to remove the pessary were challenging, requiring the use of ring forceps, a scalpel, and a clamp. The pessary was eventually removed in segments, and the patient was fitted with a diaphragm and catheter for drainage. Due to her multiple comorbidities, she was not a candidate for fistula repair. The video emphasizes the importance of routine pessary care and highlights the risks associated with their use. No credits were given in the transcript.

Asset Caption

William D Winkelman, MD

Keywords

vaginal prolapse

Gellhorn pessary

urinary incontinence

pessary removal

routine pessary care