COMPLICATIONS AFTER PLEATED COLPOSUSSPENSION

Abstract

The case is about a 60-year-old woman with abdominal swelling, lower abdominal cramps, and occasional urine leakage triggered by coughing, sneezing, or laughing. She had no nocturia or urgency symptoms but reported significant social discomfort. Her history included two vaginal deliveries. A pelvic exam revealed mild urethral hypermobility during Valsalva, no significant pelvic organ prolapse, and a highly positive Marshall test for stress urinary incontinence (SUI). Additionally, a firm, mobile mass was palpated in the right abdomen. Ultrasound identified a 13 cm cystic formation in the right ovary with thick edges and no solid components. To assess malignancy risk, we applied our original ROMI index, evaluating serum CA-125 levels, menopausal status, personal and familial history, and ultrasound features. The patient’s ROMI score was 6, indicating low malignancy risk. Laparotomy revealed a large retroperitoneal mass adhering to the right ureter, necessitating J-J stent placement. A successful tumor excision was performed, followed by an abdominal hysterectomy and our modified Pleated Colposuspension after Antovska for SUI correction.