Infected Vaginal Cuff Hematoma Cellulitis or Abscess

CLINICAL FEATURES A vaginal cuff is formed during a hysterectomy and is composed of the contiguous retroperitoneal space immediately above the vaginal apex and the surrounding soft tissue. This cuff may become infected, leading to cellulitis, hematoma, or abscess.

Vaginal cuff cellulitis is a common complication following both abdominal and vaginal hysterectomy. Symptoms and signs usually present between postoperative days 3 and 5, and may begin in the hospital, or just after discharge. Patients often complain of lower abdominal pain, pelvic pain, back pain, fever, and abnormal vaginal discharge. Induration, tenderness of the vaginal cuff, and possibly a purulent discharge or labial edema or erythema are prominent during the pelvic examination. The white blood cell count is usually elevated.

A vaginal cuff abscess usually presents early in the postoperative course. Patients complain of fever, chills, pelvic pain, and rectal pressure. On examination, lower abdominal and vaginal cuff tenderness is present. A tender fluctuant mass near the cuff may be palpable, and purulent drainage from the cuff may be seen.

Infected cuff hematomas may present later in the postoperative course and are associated with a decrease in the patient's hemoglobin and hematocrit levels. The hematoma may not be palpable on examination.

DISPOSITION Patients should be readmitted for drainage and intravenous antibiotics. Broad-spectrum antibiotics should be started early, with coverage for gram-negative, gram-positive, and anaerobic organisms. A CT scan may be necessary for diagnosis or to better define an abscess or hematoma.

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Responses

  • Emilia
    What is a vaginal cuff?
    8 years ago
  • gerald
    What are the signs and symtoms vaginal cuff cellulitis?
    8 years ago
  • faramond
    How do you test for vaginal cuff abscess?
    8 years ago
  • Aziz
    What is the drainage from the vaginal cuff?
    8 years ago
  • NADIA
    How common is vaginal cuff cellulitis?
    8 years ago
  • tuomo
    How to remove vaginal cuff abcess?
    4 years ago
  • marina
    What causes vaginal abscesses around the historectomy cuff?
    4 years ago
  • Isacco
    Is apex a vigina infection?
    3 years ago
  • Gordon
    How long will vaginal cuff abcess drain?
    3 years ago
  • EGLANTINE
    How to drain vaginal cuff cellulitis infection?
    3 years ago
  • michael
    What is the procedure for drainage for vaginal cuff abcess?
    3 years ago
  • marjorie
    How to treat a vaginal cuff hematoma?
    2 years ago
  • Prospero
    How do infections of the vaginal cuff present?
    2 years ago
  • Alvin
    How do you know you have a torn vaginal cuff?
    1 year ago
  • Rosalia
    What causes vaginal cuff infect?
    1 year ago
  • azzeza
    Can torn vaginal cuff cause lower back pain?
    1 year ago
  • ulpu
    Why so namy antibiotics after small vaginal cuff tear?
    1 year ago
  • jyri
    What is an SRC absess from vaginal cuff?
    8 months ago

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