Rationale: Concurrent pelvic organ prolapse (POP) and rectal prolapse is a rare condition that poses significant therapeutic challenges. A customized, multidisciplinary strategy is frequently required, particularly in complex cases with underlying functional deficits. Patient concerns: A 71-year-old woman presented with stage III POP and grade V rectal prolapse. Her history included no pregnancies or vaginal intercourse, and she previously underwent sacral tumor excision resulting in anal and urinary incontinence, requiring long-term catheterization. Diagnoses: Preoperative clinical examination and imaging (transabdominal and transvaginal ultrasound) confirmed the diagnosis of stage III POP and grade V rectal prolapse. Routine blood tests, vaginal bacteriological cultures, and Pap smear were unremarkable. Interventions: The patient underwent a multidisciplinary surgical procedure including hysterectomy, sacrocolpopexy, and rectopexy using a Pro-Grip™ self-fixating mesh. The mesh was placed to anchor the vaginal stump and provide rectal support simultaneously. Outcomes: The patient had an uneventful recovery, with drain removal on postoperative day 5 and discharge on day 7. Follow-up at 3 months, 6 months, and 1 year showed no recurrence of prolapse. The patient declined additional imaging at 1 year, considering herself fully recovered. Lessons: This case demonstrates that a self-fixating mesh can provide effective concurrent repair of POP and rectal prolapse in a single procedure. Short-term outcomes were favorable, but long-term follow-up remains essential to assess durability and potential complications.

The COVID-19 pandemic has significantly impacted healthcare-seeking behaviors, leading to delayed cancer diagnoses due to hospital-related anxiety. This case highlights the severe consequences of delayed medical consultation in a patient with advanced ovarian cancer. A 47-year-old female presented with severe abdominal distension, massive ascites, and extensive abdominal wall necrosis after avoiding medical care for months due to severe hospital-related anxiety, exacerbated by the loss of her husband during the COVID-19 pandemic. On admission, a CT scan could not be performed due to the patient’s inability to lie supine and extreme abdominal distension. To relieve pressure and improve respiratory function, an abdominal drain was inserted, releasing 72 L of ascitic fluid over five days. Following drainage, imaging confirmed a large ovarian tumor with peritoneal involvement, and a multidisciplinary team (surgeons, gynecologists, plastic surgeons, anesthetists, and intensive care specialists) determined the need for surgical intervention. Histopathology confirmed mucinous adenocarcinoma with pseudomyxoma peritonei (FIGO IIIB). This case underscores the critical impact of delayed oncological diagnosis and the need for enhanced patient education, mental health support, and structured screening programs to prevent similar late-stage presentations.

Background: Pelvic exenteration is an ultra-radical surgical procedure described by Brunschwig in 1948, which attempts to surgically cure patients with recurrent pelvic cancer after radiotherapy. Several variants of pelvic exenteration are described that allow a more limited or extensive resection, depending on the stage of the disease. Case report: We report the case of a 54-year-old woman, who was diagnosed with a tumoral rectovaginal fistula after a recurrent cervical cancer that had been treated with a total hysterectomy with bilateral adnexectomy and a left percutaneous nephrostomy, as well as interaortocaval lymph node resection. The patient had undergone a supralevator total pelvic exenteration with pelvic and interaortocaval lymphadenectomy. The reconstruction process included right ureterostomy, left nephrostomy, and colocutaneous anal anastomosis (Parks procedure). Conclusions: Supralevator total pelvic exenteration provides hope for cure in patients with pelvic malignancies that reappear after radiotherapy. The restoration of the digestive tract and avoiding colostomy with a colocutaneous anastomosis increases the quality of life in these cases.