Pelvic organ prolapse (POP) is a common condition affecting older women. POP can cause hydronephrosis in some patients. Although rare, especially in the subset of patients with vaginal vault prolapse, unrecognized obstructive hydronephrosis can result in renal impairment and urosepsis. We present a case of a 69-year-old female with obstructive urosepsis on a background of vaginal vault prolapse. The case highlights the importance of early recognition and intervention of obstructive urosepsis in patients with severe POP disease.
Level of evidence: Not applicable for this multicentre audit.
PersuCChappleCRCauniV, et al. Pelvic Organ Prolapse Quantification System (POP-Q): a new era in pelvic prolapse staging. J Med Life2011; 4(1): 75-81.
2.
MeinhardtWSchuitemakerNWSmeetsMJ, et al. Bilateral hydronephrosis with urosepsis due to neglected pessary. Case report. Scand J Urol Nephrol1993; 27(3): 419-420.
3.
JonesKAShepherdJPOliphantSS, et al. Trends in inpatient prolapse procedures in the United States, 1979-2006. Am J Obstet Gynecol2010; 202(5): 501.e1-7.
4.
SiddiqueMIngrahamCKudishB, et al. Hydronephrosis associated with pelvic organ prolapse: a systematic review. Female Pelvic Med Reconstr Surg2020; 26(3): 212-218.
5.
BeverlyCMWaltersMDWeberAM, et al. Prevalence of hydronephrosis in patients undergoing surgery for pelvic organ prolapse. Obstet Gynecol1997; 90(1): 37-41.
6.
WeeWWWongHFLeeLC, et al. Incidence of hydronephrosis in severe uterovaginal or vault prolapse. Singapore Med J 2013; 54(3): 160-162.
7.
CostantiniELazzeriMMeariniL, et al. Hydronephrosis and pelvic organ prolapse. Urology2009; 73(2): 263-267.
8.
LeanzaVCiottaLVecchioR, et al. Hydronephrosis and utero-vaginal prolapse in postmenopausal women: management and treatment. G Chir2015; 36(6): 251-256.
9.
HuiSYChanSCLamSY, et al. A prospective study on the prevalence of hydronephrosis in women with pelvic organ prolapse and their outcomes after treatment. Int Urogynecol J2011; 22(12): 1529-1534.
