Complex Cases in Urogynecology: Expert Insights_OnDemand-Presentation Slides

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This document is a series of cases presented by the American Urogynecologic Society (AUGS) addressing complex issues in urogynecology. Each case is briefly described, along with relevant medical history and diagnostic findings. The aim of the cases is to provide expert insights into the management of these challenging conditions.<br /><br />Case one involves a 39-year-old woman with vaginal pain and bulge. An MRI reveals a mass in the right perineum, and there are concerns for abscesses internally. The patient is referred to a CRS (Certified Registered Specialist), but they decline to operate, and the patient is sent back for management.<br /><br />Case two is a 65-year-old woman who had undergone surgery for stage IV UVP (uterovaginal prolapse) three weeks prior and experienced complications with urinary retention, bleeding, and a pelvic hematoma. Attempts to pass a wire for stent placement have been unsuccessful. The patient is referred for further management.<br /><br />Case three involves an 89-year-old woman with stool leakage per vagina after prior pelvic surgeries. CTAP (computed tomography angiography) and a barium enema show extensive stool burden but no fistulous connection. Conservative management for constipation has not been successful, and the patient returns for discussion of next steps.<br /><br />Case four is a 72-year-old patient with recurrent vaginal bulge and a history of abdominal and robotic-assisted sacrocolpopexy. The patient also experiences constipation, but no further recommendations are given for management.<br /><br />Case five presents a 42-year-old patient with vaginal stenosis due to Crohn's disease and prior surgeries. The patient is not up to date on cervical cancer screenings and is planning future surgery.<br /><br />Case six involves a 75-year-old patient with overactive bladder who developed C. diff infection after being prescribed prophylactic antibiotics for surgery. The antibiotics are stopped, and a different medication is started.<br /><br />Case seven is a 41-year-old woman with a postpartum vesicouterine fistula who wishes to avoid surgery.<br /><br />Finally, case eight is a 44-year-old patient with liver failure and ascites who presents with vaginal bulge symptoms. The patient is awaiting a liver transplant.<br /><br />The document concludes with a request for questions and a thank you message from AUGS.
Keywords
urogynecology
cases
vaginal pain
abscesses
surgery
urinary retention
uterovaginal prolapse
constipation
Crohn's disease
liver transplant