Obstet Gynecol Sci.  2018 Jul;61(4):533-536. 10.5468/ogs.2018.61.4.533.

Vaginal sling implant misdiagnosed as rectal subepithelial tumor

• Kim SM
• Han JS
• Park JW
• Kim JS
• Namgung H
• Kang YD

• KMID: 2439729
• DOI: http://doi.org/10.5468/ogs.2018.61.4.533

Abstract

As cosmetic procedures receive increasing attention from the media, female genital cosmetic surgery (FGCS) has become quite popular in Korea. The safety and efficacy of these surgeries and procedures have yet to be thoroughly documented. We report a case of a 47-year-old woman who underwent a vaginal sling implantation, which resulted in the misdiagnosis of a rectal subepithelial tumor during endoscopic mucosal resection (EMR). This patient suffered an iatrogenic rectal perforation during the EMR, which necessitated an exploratory operation. The sling implant was removed via the vaginal approach, and a primary repair of the vaginal and rectal walls was performed. The patient subsequently showed no sign of complication at her 6-month follow-up. Patients need to be educated about the importance of reporting a history of FGCS prior to undergoing surgical or endoscopic procedures. Also, physicians have to check the medical history of patient thoroughly to avoid misdiagnoses and unnecessary treatment.

Keyword

Female genitalia; Cosmetic surgery; Rectal tumor

MeSH Terms

Diagnostic Errors
Female
Follow-Up Studies
Genitalia, Female
Humans
Korea
Middle Aged
Rectal Neoplasms
Surgery, Plastic

Figure

• 

  Fig. 1 (A) Colonoscopy revealed a protruding lesion, which was located 3 cm from the anal verge and measured 8 mm in diameter. (B) The tip of the silicone tube was discovered due to an iatrogenic rectal perforation during the endoscopic mucosal resection. (C) Transvaginal gray-scale ultrasonography showed a tubular, echogenic structure between the lower vagina and the rectum (arrow).

• 

  Fig. 2 The vaginal sling implant measuring 15 cm was removed via the vaginal approach.

Reference

1. Heo GE, Kim TH, Lee HH, Kim JM. Concerns about female genital cosmetic surgery, especially cosmetic vaginoplasty, in South Korea. Acta Obstet Gynecol Scand. 2016; 95:247.

2. Shaw D, Lefebvre G, Bouchard C, Shapiro J, Blake J, Allen L, et al. Female genital cosmetic surgery. J Obstet Gynaecol Can. 2013; 35:1108–1112.

3. Royal College of Obstetritians and Gyneacologists. Ethical opinion paper [Internet]. London (UK): Royal College of Obstetritians and Gyneacologists;c2013. cited 2013 Nov 15. Available from: https://www.rcog.org.uk/en/news/joint-rcogbritspag-release-issues-surrounding-women-and-girls-undergoing-female-genital-cosmetic-surgery-explored/.

4. Goodman MP. Female genital cosmetic and plastic surgery: a review. J Sex Med. 2011; 8:1813–1825.

5. Committee on Gynecologic Practice, American College of Obstetricians and Gynecologists. ACOG Committee Opinion No. 378: Vaginal “rejuvenation” and cosmetic vaginal procedures. Obstet Gynecol. 2007; 110:737–738.

6. Mirzabeigi MN, Moore JH Jr, Mericli AF, Bucciarelli P, Jandali S, Valerio IL, et al. Current trends in vaginal labioplasty: a survey of plastic surgeons. Ann Plast Surg. 2012; 68:125–134.

7. Women's Health Committee. Vaginal ‘rejuvenation’, laser ablation for benign conditions and cosmetic vaginal procedures [Internet]. Melbourne (AU): The Royal Australian and New Zealand College of Obstetricians and Gynaecologists;c2015. cited 2015 Mar. Available from: https://www.ranzcog.edu.au/.

8. Singh A, Swift S, Khullar V, Digesu GA. Laser vaginal rejuvenation: not ready for prime time. Int Urogynecol J Pelvic Floor Dysfunct. 2015; 26:163–164.

9. Goodman MP, Placik OJ, Benson RH 3rd, Miklos JR, Moore RD, Jason RA, et al. A large multicenter outcome study of female genital plastic surgery. J Sex Med. 2010; 7:1565–1577.

10. Kelly B, Foster C. Should female genital cosmetic surgery and genital piercing be regarded ethically and legally as female genital mutilation? BJOG. 2012; 119:389–392.