A case of laparoscopically assisted vulvar reconstruction using the gluteal fold flap for anterior enterocele after robot-assisted radical cystectomy in a woman.

Abstract

<h4>Introduction</h4>Vaginal complications following radical cystectomy may require surgical treatment. We herein report a case of successful laparoscopically assisted vulvar reconstruction using the gluteal fold flap for anterior enterocele following robot-assisted radical cystectomy.<h4>Case presentation</h4>A 71-year-old Japanese woman underwent robot-assisted radical cystectomy for bladder cancer (ypT1ypN1M0). The bladder, urethra, bilateral ovaries, and anterior vaginal wall were removed together transvaginally. The Mercedes-Benz closure technique was performed for vaginal reconstruction using the posterior vaginal wall. Seventeen months after surgery, she complained of a vulvar bulge, and physical examination confirmed a tennis ball-sized anterior enterocele. Therefore, she underwent laparoscopically assisted vulvar reconstruction using the gluteal fold flap. No recurrence had developed at 6 months postoperatively.<h4>Conclusion</h4>The combination with laparoscopy allows vulvar reconstruction to be performed safely and efficiently.