Uterine Retroversion for Vaginoperineal Reconstruction Following Resection of Distal Rectal Tumors

Abstract

Uterine retroversion is a viable option for vaginal and perineal reconstruction.

Successful reconstructive surgery to alter distorted vaginal axis causing apareunia

“…Post-exenterative vaginal reconstruction usually described in the literature refers to repair of pelvic fl oor and vaginal wall defects, rather than axis deviation (Berger et al 2010;Rettenmaier et al 2006;Castillo et al 2010). In a recent case report by Rettenmaier, successful reconstruction of a neovagina following pelvic exenteration was possible using an InteXen porcine mesh with the Apogee Ô and Perigee Ô devices (American Medical Systems, MN) (Rettenmaier et al 2006).…”

Co-Operative Radical Pelvic Surgery

“…The use of the intact uterus has been described in posterior vaginal wall reconstruction after proctectomy. 13 This is the first description of a uterine myoserosal flap reconstruction in posterior pelvic floor reconstruction.…”

“…Retroversion of the intact uterus has been described in filling the posterior defect created by proctectomy with excision of the posterior vaginal wall and was followed by satisfactory functional outcome and squamous epithelialization of the serosa. 13 Our exploration of this technique revealed that the intact uterus is not long enough to reach the skin edge posteriorly after the excision of anorectal cancer, especially when the perineum is excised. Anteversion of the intact uterus to fill the anteior pelvic floor after cystourethrectomy failed because the fundus of the uterus was too bulky to sit under the pubic arch and too short to reach the vestibule.…”