ABSTRACT

A grandmultiparous (G7P5) 78 year old woman presented with total procidentia with total eversion of the vagina which was oedematous and ulcerated. She complained of dribbling of urine, urgency and urge incontinence. She was very keen on surgical repair. Vaginal packing, single and double vaginal ring pessaries had failed to reduce the procidentia preoperatively. She was fitted with three ring pessaries: size 59 mm was inserted first, then 77mm followed by 95mm. This resulted in reducing her genital prolapse which allowed the vaginal ulcers to heal before a definitive surgery by vaginal hysterectomy, and total prolift procedure was undertaken about one month later. The procedure and recovery were uncomplicated and when reviewed 7 weeks postoperatively, she was asymptomatic with excellent vaginal support.