Effectiveness of the McCall culdeplasty in maintaining support after vaginal hysterectomy

Abstract

The aim of this study was to evaluate the effectiveness of a McCall culdeplasty in maintaining support of the post-hysterectomy vaginal cuff in women undergoing surgery for uterine prolapse. A retrospective chart review was performed on all patients who had a vaginal hysterectomy and McCall culdeplasty for uterine prolapse without prolapse of the posterior vaginal fornix. Patients were examined pre- and postoperatively using the International Continence Society (ICS) staging system. Data were analyzed using repeated measures analysis of variance (ANOVA) for correlation between preoperative point D and the two postoperative point C measurements. Of the 43 patients studied, 39 (90%) had stage 0 prolapse and 3 (7%) had stage I prolapse of the vaginal cuff 1 year postoperatively. In patients who have hysterectomies for uterine prolapse with good support of the posterior vaginal fornix, the McCall culdeplasty is a highly successful procedure in maintaining proper anatomic support of the vaginal cuff.

Vaginal surgery for uterine descent; which options do we have? A review of the literature

“…Therefore, 15 studies were excluded. Twenty-three studies were available in which outcome data for 1,764 women who underwent a vaginal hysterectomy for prolapse symptoms were analyzed separately, with a follow-up of between 9 and 60 months [4,5,6,[9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28].…”

Rectocele and intussusception: is there any coherence in symptoms or additional pelvic floor disorders?

“…There are different procedures described in the literature for preventing the occurrence of an enterocele after hysterectomy, and of these Cruikshank considers the McCall culdeplasty to be the method of choice [11]. This technique reattaches the vaginal cuff to its support structures, obliterates the cul-de-sac between the vagina and the anterior rectal wall, and suspends the posterior vaginal wall [31]. Another operation, the sacrocolpopexy, performed openly or laparoscopically, lifts up the vagina to its natural position by attaching it by a mesh at the sacrum [32].…”

Anatomical and functional results of McCall culdoplasty in the prevention of enteroceles and vaginal vault prolapse after vaginal hysterectomy

“…However, like Montella and Morrill [7], we recorded only those patients who presented no prolapse of the vaginal vault or prior enterocele and who had undergone preventive culdoplasty and vaginal vault fixation.…”

“…The criteria used to compare results were the same as those of Montella and Morrill [7]. After the McCall culdoplasty, we considered a vaginal vault at point C (<−2 cm) or stage 0 as a successful outcome.…”