No abstract

No abstract

Uterine prolapse can be treated by various conservative or operative measures. If the patient wishes operative correction with removal of the uterus, the gold standard is vaginal hysterectomy. The surgical steps are basically the same as those used for vaginal hysterectomies performed for other, benign, uterine pathologies. However, in hysterectomy procedures for prolapse, the focus is on treating the apical insufficiency and preventing prolapse of the vaginal stump, i.e. socalled vaginal vault suspension. However, clinical practice has shown that in addition to attempting a topographically and physiologically correct suspension, techniques for additional fixation are used which entail anatomical compromises. And vaginal vault suspension is often not sufficiently taken into account. The selection of a specific approach is often not entirely based on scientific reasons. Usually the choice of approach is based on the surgical technique learned individually, the physicianʼs own ideas and experiences, and techniques seen elsewhere. The authors do not exempt themselves.

We hereby present a trial of a high-risk group of patients requiring reconstruction of anterior and apical vaginal wall in mostly recurrent prolapse situation. Our data support the hypothesis of improved anatomical and functional results and less mesh shrinkage caused by the single-incision technique with fixation in sacrospinous ligament in combination with modification in mesh quality compared to former multi-incision techniques.

Preoperative URP does not correlate with SUI in all women, has no predictive value, and does not correlate with the outcome of anti-incontinence surgery. However, there seems to be an association with biomechanical factors such as obesity, which may open up a new area of application for URP measurement in urogynecologic diagnosis.

Our surgical technique without permanent material offers good apical support and functional and subjective results. Anatomical improvement was achieved in all cases of cystocele repair. Recurrent cystoceles are often asymptomatic.

Die interstitielle Zystitis wird nach wie vor zu selten diagnostiziert. Patienten haben oft einen langen Leidensweg hinter sich, bevor die richtige Diagnose gestellt und eine erfolgversprechende Therapie ein geleitet wird. Auch wenn die Pathophysiologie noch immer nicht ganz geklärt ist, existieren multiple Behandlungsansätze.

Die interstitielle Zystitis wird nach wie vor zu selten diagnostiziert. Patienten haben oft einen langen Leidensweg hinter sich, bevor die richtige Diagnose gestellt und eine erfolgversprechende Therapie ein geleitet wird. Auch wenn die Pathophysiologie noch immer nicht ganz geklärt ist, existieren multiple Behandlungsansätze.