A 48-year-old Kenyan national comes with history of pain in abdomen for 1 month and difficulty in passing urine. She also complains of brownish discharge. She complains of having to strain for micturition in sitting position. On standing the urine flows out. She has 11 children. 7 of them were by normal delivery. The last four were by caesarean section.
In her last delivery. She had PPH and supracervical hysterectomy was done in Kenya. She has undergone TVTO at a hospital in India for complains of? involuntary passage of urine, (history is vague) she says she was alright for some time, but now her "symptoms" which now at least is straining at micturition has recurred. On examination she has a cervix which looks healthy but is high up in the pelvis, probably pulled up by adhesions. She has tender vault and tender left iliac fossa. She has taken many antibiotics in the past 1month, but…
