Question

A 67-year-old G3P3 woman presents with severe pelvic protrusion status post hysterectomy. She denies any incontinence. She failed conservative management with a pessary. She underwent a vaginal surgical repair where the pubocervical fascia was plicated in the midline as well as laterally to the arcus tendineus fascia (white line). What defect was repaired in this patient?

A. Cystocele
B. Rectocele
C. Uterine prolapse
D. Enterocele
E. Urethral diverticulum

Answer 1

A 67-year-old woman underwent vaginal surgical repair for a cystocele, which is the prolapse of the bladder into the vagina, by plicating the pubocervical fascia.

Step-by-step explanation:

The defect repaired in the 67-year-old G3P3 woman with severe pelvic protrusion status post hysterectomy was a cystocele. Cystocele refers to the prolapse of the bladder into the vagina, which can happen when the supportive tissue between a woman's bladder and vaginal wall weakens and stretches. Since the surgery described involved plicating the pubocervical fascia in the midline as well as laterally to the arcus tendineus fascia, this indicates that the anterior vaginal wall, which supports the bladder, was the focus of the repair. Hence, A. Cystocele is the correct answer to the question about which defect was repaired in the patient.