Results of vaginal hysterectomy; Immediately and two and one-half to seven years after operation

This study was designed to gain more information about morphology of the vagina after hysterectomy. The prospective clinical observations of patients subjected to abdominal or vaginal extrafascial or intrafascial hysterectomy with or without correction of anatomical urinary stress incontinence were included. The length, configuration and axis of the vagina were determined using a vaginal cast technic. Vaginal casts were prepared prior to and 6 months to 4 years after surgery. The gross appearance of the vagina after hysterectomy is affected by understanding normal pelvic anatomy an physiology, careful preoperative evaluation of pelvic defects, proper planning and competent performance of surgery. Proper handling of the endopelvic fascia and its condensations, the cardinal and sacrouterine ligaments, corrects preexisting weakness, provides vaginal suspension and prevents future vaginal disfigurement. Inadequate surgical technics result in magnifying preexisting weakness of pelvic supports. Successful surgery involves correcting the levator complex by reducing and shifting the levator hiatus ventrally. Reconstruction of the perineal body is essential. This study suggests a relationship between successful surgical treatment of urinary stress incontinence and reconstruction of pelvic supportive structures, with restoration of the physiological vaginal axis.

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A Vaginal Approach to the Treatment of Genital Prolapse

Tanaka

Yamamoto

Shimano

et al. 1988

Asia-Oceania Journal of Obstetrics and Gynaecology

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A series of 84 cases of genital prolapse, operated on at our clinic by way of vaginal hysterectomy with anterior and posterior colporrhaphy during 1976-1985, was clinically analyzed in this study.The cases included 1 nullipara, 1 primipara, 56 cases from para I1 to V and 26 cases para VI or more.Vaginal hysterectomy with anterior colporrhaphy was performed on 58% of the cases and vaginal hysterectomy with anterior and posterior colporrhaphy was carried out in 41% of the cases. Vaginal hysterectomy with posterior colporrhaphy was performed in only 1 % of the cases.Immediate postoperative complications took the form of residual urine in 12 cases of vaginal hysterectomy with anterior colporrhaphy. There was no recurrence in our series after operation.

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Results of vaginal hysterectomy; Immediately and two and one-half to seven years after operation

Cited by 7 publications

References 9 publications

The repair of genital prolapse

The repair of genital prolapse

Vaginal morphology following hysterectomy

A Vaginal Approach to the Treatment of Genital Prolapse

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