1. A Case of Prolapsed Uterus with Stone Bladder
Presented by
Dr. Narayan M. Patel
M.D.,D.G.O. FICS
Emeritus Professor Muni. Medical college
Postal address--
Mahalaxmi Institute of medical teaching,
3, Shantiniketan park, Naranpura,
Nr.Sardar Patel Colony,
AHMEDABAD (Gujarat) INDIA
T.N.(079) , Mobile;
E mail:-

2. This patient aged about 50 years
came with c/o some thing
coming out of vagina and
burning maturation.
She had procedentia as shown
in this picture
In India, in the state of Gujarat, where I am practicing, some
district have vary hard drinking water, with plenty of salts.
In these areas, Kidney stones, ureteric stones and bladder
stones are vary common. It is our practice to get x-ray
done in long standing prolapse cases. We got her x-ray
pelvis after reducing the prolapse, and in the next slide
you will see 2 stones in urinary bladder.

3. If we had taken x-ray pelvis without reducing
Stone
X-ray pelvis shows
2 stones, quite big
in size.
Stone
If we had taken x-ray pelvis without reducing
prolapse, then the stones will be seen out of pelvis,
This patient was given antibiotics and then was
taken up for operation, under spinal anesthesia.
At operation, it is always safe to first remove stones
and then proceed for hysterectomy

4. Ant. vaginal wall.
Bladder
You see in this picture that, anterior vaginal wall is separated
from underneath bladder. The bladder bulge is seen.
Ellis forceps are holding anterior vaginal wall on either side.
Folleys catheter is in the bladder.

5. Stones
Stones
Bladder was opened up with knife and we could locate
stoned in it. They were carefully removed and a good wash
was given to the area, Bladder was sutured in 2 layers
by vicryl 2/0 suture. Folleys catheter was kept in for, about 10
days, in post operative period. Recover was uneventful.

6. After suturing bladder, we proceed doing vaginal hysterectomy
in the usual manner. Bladder was emptied more often during
The hysterectomy procedure. You see the uterus that was
Removed and also the stones by its side.
Anterior and posterior repair were done as usual..
Intentional opening of bladder and then care full suturing it,
do not give rise to any complications. We have followed this
procedure in a number of cases, without any complication.

7. Thank you