Unilateral vulvar oedema after laparoscopy: aetiology and management of a rare complication

Orli M. Silverberg, A. Hasan, Ahmad Hasan, Amy Zhu, Nigel Pereira
In: BMJ Case Reports · 2025 · vol. 18(2) , pp. e264773 · doi:10.1136/bcr-2024-264773 · PMID:39986672 · W4407854401
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Abstract

Laparoscopy is frequently used for the minimally invasive treatment of various gynaecological pathologies. Compared with laparotomy, laparoscopy is associated with faster recovery, better incision cosmesis, shorter hospital stays and lower postoperative pain and complications. Vulvar and/or labial oedema is an exceptionally rare postoperative complication of laparoscopy, and in this context, we present the case of a patient who developed unilateral vulvar oedema several hours after an uncomplicated laparoscopic ovarian cystectomy. The patient was managed expectantly, and she made a full recovery within 24 hours. Postlaparoscopic vulvar oedema occurs most commonly after ovarian cystectomy, although it has been described after laparoscopic presacral neurectomy and bilateral salpingectomy. The exact aetiology of this complication remains unclear; however, proposed mechanisms include a patent canal of Nuck or passage of fluid through the subcutaneous tissue to the most dependent area.

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