Uterine Ischemia Secondary to Chronic Procidentia: A Rare Complication of Advanced Pelvic Organ Prolapse

Abstract

Background:
Uterine ischemia is an uncommon condition typically associated with uterine artery embolization or malignancy.
Case Report:
We report a rare case of uterine ischemia secondary to complete uterine prolapse in a generally healthy 53-year-old woman with fourth degree prolapse (procidentia). The patient had undergone significant weight loss prior to elective pelvic reconstructive surgery. At the time of the planned abdominal subtotal hysterectomy and sacrocervicopexy unexpected findings included uterine ischemia with necrotic areas and diffuse peritoneal inflammation. Due to concerns about tissue integrity the intended procedure was modified.
Conclusion:
This case highlights a previously unreported complication of advanced uterine prolapse and raises the possibility of vascular compromise exacerbated by mechanical factors and rapid weight loss. Awareness of this rare complication may aid surgical planning in similar cases.