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CEN Case Reports

, Volume 6, Issue 2, pp 125–128 | Cite as

A case of renal dysfunction caused by pelvic organ prolapse

  • Ai MiyagiEmail author
  • Yusuke Inaguma
  • Tomoaki Tokoyoda
  • Takashi Nakajima
  • Ryozo Sezaki
  • Tetsuya Matsukawa
Case report

Abstract

Pelvic organ prolapse (POP) is the descent of pelvic organs through the vagina, and sometimes causes hydronephrosis. Although the association between POP and hydronephrosis has long been recognized, severe hydronephrosis and renal dysfunction are rarely seen. We report a case of 66-year-old woman who had a vaginal delivery presented with externalized uterine and bladder prolapse during the previous 2 years. She had a 3-day history of hypophagia and vomiting, and laboratory analysis resulted in serum creatinine of 5.75 mg/dL and blood urea of 78.1 mg/dL. The patient was treated urgently with vaginal pessary to return the uterine and bladder into the pelvis. After 2 weeks, her serum creatinine dropped to 3.66 mg/dL, but chronic renal failure persisted. Hydronephrosis caused by POP may lead to renal dysfunction and can advance to irreversible renal damage if left untreated. Important is early evaluation of renal function and images of the kidney and ureter.

Keywords

Pelvic organ prolapse Renal dysfunction Hydronephrosis Obstructive nephropathy 

Notes

Conflict of interest

The authors have declared that no conflict of interest exists.

Human and animal rights

This article does not contain any studies with human participants performed by any of the authors.

Informed consent

Informed consent was obtained from participants included in the article.

References

  1. 1.
    Costantini E, Lazzeri M, Mearini L, Zucchi A, Del Zingaro M, Porena M. Hydronephrosis and pelvic organ prolapse. Urology. 2009;73(2):263–7.CrossRefGoogle Scholar
  2. 2.
    Gerten KA, Markland AD, Lloyd LK, Richter HE. Prolapse and incontinence surgery in older women. J Urol. 2008;179(6):2111–8.CrossRefGoogle Scholar
  3. 3.
    Altok M, Feyzullah ŞA, Umul M, Güneş M. Severe hydronephrosis caused by uterine prolapse with non pecific symptoms and normal renal function. Int J Women’s Health Reproduction Sci. 2013;1(3):111–4.CrossRefGoogle Scholar
  4. 4.
    Kong MK, Bai SW. Surgical treatments for vaginal apical prolapse. Obstet Gynecol Sci. 2016;59(4):253–60.CrossRefGoogle Scholar
  5. 5.
    Jelovsek JE, Maher C, Barber MD. Pelvic organ prolapse. Lancet. 2007;369(9566):1027–38.CrossRefGoogle Scholar
  6. 6.
    Slieker-ten Hove MC, Pool-Goudzwaard AL, Eijkemans MJ, Steegers-Theunissen RP, Burger CW, Vierhout ME. Symptomatic pelvic organ prolapse and possible risk factors in a general population. Am J Obstet Gynecol. 2009;200(2):184.e1–7.CrossRefGoogle Scholar
  7. 7.
    Beverly CM, Walters MD, Weber AM, Piedmonte MR, Ballard LA. Prevalence of hydronephrosis in patients undergoing surgery for pelvic organ prolapse. Obstet Gynecol. 1997;90(1):37–41.CrossRefGoogle Scholar
  8. 8.
    Gemer O, Bergman M, Segal S. Prevalence of hydronephrosis in patients with genital prolapse. Eur J Obstet Gynecol Reprod Biol. 1999;86(1):11–3.CrossRefGoogle Scholar
  9. 9.
    Leanza V, Ciotta L, Vecchio R, Zanghì G, Maiorana A, Leanza G. Hydronephrosis and utero-vaginal prolapse in postmenopausal women: management and treatment. G Chir. 2015;36(6):251–6.PubMedGoogle Scholar
  10. 10.
    ACOG Committee on Practice Bulletins–Gynecology. Obstet Gynecol. 2007;110(3):717–29.CrossRefGoogle Scholar
  11. 11.
    Bump RC, Mattiasson A, Bø K, Brubaker LP, DeLancey JO, Klarskov P, Shull BL, Smith AR. The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol. 1996;175(1):10–7.CrossRefGoogle Scholar
  12. 12.
    Brettauer J, Rubin IC. Hydroureter and hydronephrosis: a frequent secondary finding in cases of prolapse of the uterus and bladder. Am J Obstet Gynecol. 1923;6:696–708.CrossRefGoogle Scholar
  13. 13.
    Kurt S, Guler T, Canda MT, Demirtas Ö, Tasyurt A. Treatment of uterine prolapse with bilateral hydronephrosis in a young nulliparous woman; a new minimally invasive extraperitoneal technique. Eur Rev Med Pharmacol Sci. 2014;18(11):1657–60.PubMedGoogle Scholar
  14. 14.
    Melser M, Miles BJ, Kastan D, Shetty PC, Anderson W. Chronic renal failure secondary to post-hysterectomy vaginal prolapse. Urology. 1991;38(4):361–3.CrossRefGoogle Scholar
  15. 15.
    Klahr S, Morrissey J. Obstructive nephropathy and renal fibrosis. Am J Physiol Renal Physiol. 2002;283:F861–F875CrossRefGoogle Scholar
  16. 16.
    Vaughan ED Jr, Gillenwater JY. Recovery following complete chronic unilateral ureteral occlusion: functional, radiographic and pathologic alterations. J Urol. 1971;106(1):27–35.CrossRefGoogle Scholar
  17. 17.
    Shokeir AA, Provoost AP, Nijman RJ. Recoverability of renal function after relief of chronic partial upper urinary tract obstruction. BJU Int. 1999;83(1):11–7.CrossRefGoogle Scholar
  18. 18.
    Lamers BH, Broekman BM, Milani AL. Pessary treatment for pelvic organ prolapse and health-related quality of life: a review. Int Urogynecol J. 2011;22(6):637–44.CrossRefGoogle Scholar
  19. 19.
    Ellington DR, Richter HE. Indications, Contraindications, and Complications of Mesh in Surgical Treatment of Pelvic Organ Prolapse. Clin Obstet Gynecol. 2013;56(2):276–88.CrossRefGoogle Scholar
  20. 20.
    Chevalier RL, Thornhill BA, Wolstenholme JT. Renal cellular response to ureteral obstruction: role of maturation and angiotensin II. Am J Physiol. 1999;277(1 Pt 2):F41–7.Google Scholar
  21. 21.
    Jones EA, Shahed A, Shoskes DA. Modulation of apoptotic and inflammatory genes by bioflavonoids and angiotensin II inhibition in ureteral obstruction. Urology. 2000;56(2):346–51.CrossRefGoogle Scholar

Copyright information

© Japanese Society of Nephrology 2017

Authors and Affiliations

  1. 1.Department of NephrologyNagoya Ekisaikai HospitalNagoya CityJapan
  2. 2.Department of Obstetrics and GynecologyNagoya Ekisaikai HospitalNagoya CityJapan

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