Modified extraperitoneal uterosacral ligament suspension for prevention of vault prolapse after vaginal hysterectomy

International Urogynecology Journal
Manidip Pal, Soma Bandyopadhyay

Abstract

During vaginal hysterectomy, extraperitoneal uterosacral ligament suspension (ULS) bites can be taken before removing the uterus. We evaluated this modified extraperitoneal ULS for vault prolapse prevention. Study period was 3.5 years. Fifty-one women with third- and fourth-degree prolapse were enrolled. An inverted V incision was made on the anterior vaginal wall and continued as a semicircular incision on the posterior vaginal wall. Lateral vaginal mucosa was pushed up to expose the cardinal-uterosacral ligament complex. The first ULS suture, using polypropylene no. 1, was taken in the upper-most exposed area of the uterosacral ligament. The second suture, using polyglactin no. 1 or 0, was taken 0.5-1 cm below the first suture. During placement of both sutures, traction on the cervix was maintained. The cardinal-uterosacral ligament complex was clamped, dissected, and ligated 1 cm below the second suture. Vaginal hysterectomy was completed. Ends of the ULS suture were fastened to the vault via vesicovaginal and rectovaginal septum using polypropylene within and polyglactin outside vaginal mucosa. Prolapse stage was 3 in 42 cases and 4 in nine. Duration of operation ranged from 60 to 120 min. Blood loss was 100-300 ml. During ...Continue Reading

References

Aug 11, 2007·International Urogynecology Journal and Pelvic Floor Dysfunction·Peter L Dwyer, Brigitte Fatton
Sep 18, 2008·Current Opinion in Obstetrics & Gynecology·Taji Yazdany, Narender Bhatia
Jan 23, 2009·International Urogynecology Journal and Pelvic Floor Dysfunction·Brigitte FattonP K Tan
Sep 6, 2011·International Urogynecology Journal·Christopher P ChungBobby L Shull
Oct 25, 2011·World Journal of Urology·Kristina Cvach, Peter Dwyer
Nov 28, 2015·International Urogynecology Journal·Lin L OwPeter L Dwyer

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Citations

Apr 17, 2019·Journal of Investigative Surgery : the Official Journal of the Academy of Surgical Research·Pınar Kadiroğulları, Kerem Doga Seckin
Apr 23, 2020·International Urogynecology Journal·Ariel ZilberlichtDebjyoti Karmakar
Feb 9, 2020·International Urogynecology Journal·Manidip Pal, Soma Bandyopadhyay
Jul 6, 2020·European Journal of Obstetrics, Gynecology, and Reproductive Biology·Mustafa Ayhan EkiciUlku Mete Ural

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