Lan, a 60-year-old woman, presented with multiple gynecological issues common during menopause, including stage 2 uterine prolapse, stage 4 bladder prolapse, and a 5x6 cm ovarian cyst on her right ovary, according to Dr. Nguyen Thi Thanh Tam from the Obstetrics and Gynecology Center at Tam Anh General Hospital in Ho Chi Minh City. While her cervical cancer screening showed no abnormalities, she tested positive for 12 high-risk HPV strains linked to cancer.

Her untreated, long-standing uterine prolapse had led to ulceration and bleeding of the cervix. The prolapse caused vaginal infections and pressure on her bladder, resulting in frequent urination, incontinence, and urinary retention, which could eventually lead to kidney failure, Dr. Tam explained.

After consultation, doctors decided on a single surgery to address all of Lan's issues. The procedure included checking for malignant cells in the abdominal fluid, removing the uterus and both ovaries, excising the greater omentum, taking biopsies to assess for cancer, and repairing the pelvic floor. Post-operative pathology confirmed a benign ovarian cyst and no malignant cells in the uterus, surrounding tissues, or abdominal fluid.

Dr. Thanh Tam (right) and the surgical team operating on Lan. Photo: Tue Diem

Estrogen plays a vital role in maintaining the strength of the pelvic floor muscles. However, estrogen levels decline during menopause. This decline, according to Dr. Tam, increases the risk of uterine prolapse in postmenopausal women. In mild cases, the prolapse remains within the vagina, causing minimal discomfort. However, if left untreated, it can worsen and lead to urinary problems such as difficulty urinating, incomplete emptying of the bladder, urinary urgency, and incontinence. Severe cases can also result in bladder infections, constipation, pelvic heaviness, cervical inflammation, and painful intercourse.

Ovarian cysts diagnosed after menopause can be dangerous and carry a higher risk of cancer compared to those found during reproductive years. Therefore, doctors recommend that women with gynecological concerns seek prompt medical attention for effective diagnosis and treatment. Regular gynecological check-ups every 6 to 12 months are advised for women of reproductive age and postmenopausal women to ensure early detection and timely treatment of any potential issues.

Tue Diem

The patient's name has been changed.