The patient is a year-old female who presented with bothersome stage III pelvic organ prolapse. She had urodynamic testing before the surgery that showed no stress urinary incontinence, no detrusor overactivity, and normal bladder capacity. The surgery was uncomplicated. She was discharged home the same day as surgery and her postoperative recovery was unremarkable. The patient is a year-old female with a past medical history of hypertension and type 2 diabetes mellitus on metformin who presented with symptoms of bothersome vaginal bulge that she had to manually reduce. She had urinary hesitancy and at times would have to lean forward to initiate voiding.
Study of sacrospinous fixation for posthysterectomy vault prolapse. - Free Online Library
She elected to undergo a sacrospinous ligament vault suspension SSLS with an anterior and posterior colporrhaphy. Surgical Indications Sacrospinous ligament vault suspension is a technique to correct post-hysterectomy vaginal vault prolapse. This technique can be slightly modified in order to perform a sacrospinous hysteropexy as a uterine-sparing technique. This technique should be considered in patients who wish to avoid synthetic material for their vault suspension. SSLS consists of an extraperitoneal approach, which is an advantage in patients with multiple previous abdominal surgeries. The pararectal space is usually not violated during abdominal surgeries making this extraperitoneal technique a safe approach in this situation to avoid bowel adhesions and injury.
Sacrospinous Vaginal Vault Suspension: Variations on a Theme
Few investigators have compared the vaginal and abdominal approaches. So how should we decide on a procedure? It is a judgment call, ultimately. Part 1 of this 2-part article reviews what is known about the most widely used and newest vaginal techniques:. In Part 2, next month, we focus on the abdominal approach, and survey the data comparing vaginal and abdominal repairs.
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