A 50-year-old female who had undergone laparoscopic total
hysterectomy at a local clinic owing to
leiomyoma of the uterus was referred to our hospital after having
dysuria, urgency, frequency, lower
abdominal pain and
right flank pain over several months. After routine examinations, cystoscopy, computed tomography and magnetic resonance imaging were performed, and non-ulcerative
interstitial cystitis accompanied by postoperative
fibrosis secondary to a previous surgery was suggested.
Pentosan sulfuric polyester (
Elmiron, Alza
Pharmaceuticals, Mountain View, CA) reduced her severely debilitating symptoms and improved her quality of life. Both the
hydronephrosis and the symptoms were relieved by ureteral
stent insertion and percutaneous nephrostomy. However, a few days later, she presented with
vaginal bleeding along with her previous symptoms, and punch biopsy of the vaginal stump resulted in a diagnosis of
adenocarcinoma. Both ureterocutaneostomy with
radical cystectomy and lower anterior resection for rectum invasion were conducted. After the slide review of the original specimen from the local clinic, she was diagnosed with recurrent
cervical cancer of the vaginal stump.