Presentation
Perineal swelling and pain and postmenopausal PV bleeding.
Patient Data
Complete prolapse of the uterus, part of rectum and urinary bladder base along with vesicoureteric junctions. Mild to moderate bilateral hydroureteronephrosis secondary to the prolapse of the urinary bladder base. No radiopaque calculi are appreciated in kidneys, ureters and urinary bladder. Mild bilateral perinephric fat stranding. Small fat-containing umbilical hernia. Calcifications (injection granulomas) noted in bilateral gluteal regions. Osteopenia and degenerative changes are seen in visualized skeleton. Old compression fracture of 12th thoracic vertebra with mild retropulsion. L5 spondylolysis without any significant spondylolisthesis. Old healed fracture of right sixth rib noted on a few sections through chest.
Case Discussion
Scan findings are consistent with pelvic organ prolapse including complete uterus, part of the rectum and part of the urinary bladder which has an appearance of cystocele. Lower ends of the both ureters are also affected in this pelvic prolapse, leading to advanced obstructive uropathy.