Vaginal Vault Suspension at Hysterectomy for Prolapse – Myths and Facts, Anatomical Requirements, Fixation Techniques, Documentation and Cost Accounting

Graefe, Flora; Marschke, Juliane; Dimpfl, T.; Tunn, Ralf

doi:10.1055/s-0032-1328061

Cited by 9 publications

(6 citation statements)

References 15 publications

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“…While posterior vaginal wall lengths at 1 st week, 1 st month, and 3 rd month were 9.5, 8.7, and 10.1 cm respectively (Table 3). Table (6) there was a significant increase in the anterior vaginal walls in 1 st week, 1 st month, and 3 rd month of follow-up. And there was a significant increase in the posterior vaginal wall during 1 st week and 3 rd month of follow-up.…”

Section: Resultsmentioning

confidence: 77%

Value of Rectus Sheath Suspension of Vaginal Vault in Total Abdominal Hysterectomy

Fathy

Emam²,

Eid³

2022

The Egyptian Journal of Hospital Medicine

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Background: Surgical management of vaginal vault prolapse post hysterectomy has improved with the use of the recto suspension technique. The technique is also used for prolapsing of the posterior vaginal wall rectus sheath suspension was described as a quick procedure with low morbidity and a short hospital stay. Objective: This study was aimed to evaluate rectus sheath suspension used as a treatment for vaginal vault prolapse after total abdominal hysterectomy. Patients and Methods: This interrupted time series clinical trial estimated the value of rectus sheath suspension of vaginal vault which was done on 50 patients undergoing total abdominal hysterectomy, at the

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Section: Resultsmentioning

confidence: 77%

Value of Rectus Sheath Suspension of Vaginal Vault in Total Abdominal Hysterectomy

Fathy

Emam²,

Eid³

2022

The Egyptian Journal of Hospital Medicine

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“…DAC and vaginal hysterectomy (and cervix extirpation) with apical fixation are standardized procedures in our clinic. We will omit the description of vaginal hysterectomy here as it was previously published by our group [ 8 , 9 ]. Following hysterectomy, DAC is performed while the epithelium of the vaginal vault is still open.…”

Section: Surgical Technique and Perioperative Proceduresmentioning

confidence: 99%

Double-layered anterior colporrhaphy (DAC)—video and mid-term follow-up of 60 patients

2022

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Introduction and hypothesis Anterior colporrhaphy (AC) exhibits high recurrence rates, and this issue is not appropriately addressed by alloplastic material, which often necessitates reoperation. Aiming to improve the anatomical cure rate, we implemented double-layered anterior colporrhaphy (DAC). With a retrospective investigation, precise description and video of the surgical technique, we want to contribute to the development of native tissue anterior repair. Methods Women treated by DAC and vaginal hysterectomy were included. Primary outcome was anatomic cure defined as prolapse < stage 2. Secondary outcomes were complication rate, resolution of postvoid residual urine, reoperation for prolapse and patient satisfaction. Follow-up encompassed a clinical gynecologic examination, the German Pelvic Floor Questionnaire and a response scale for postoperative quality of life (QoL). The key difference between DAC and AC is the continuous suture followed by the traditional interrupted sutures. Results One hundred one patients were eligible, and 60 patients attended follow-up. Cure was achieved in 49 cases (81.7%) of cystocele with a median follow-up of 19.3 months. Fifty-five patients (91.7%) indicated an improvement in QoL. Conclusions We observed high anatomic cure rate and satisfaction after DAC. With description and video of the technique, it is reproducible and comparable to other methods. Randomized controlled trials should follow. Supplementary material The online version of this article (10.1007/s00192-022-05216-3) contains supplementary material. This video is also available to watch on http://link.springer.com/ . Please search for this article by the article title or DOI number, and on the article page click on ‘Supplementary Material’.

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“…3 The usual treatment for UV prolapse is hysterectomy followed by pelvic support repair. 4,5 In young reproductive age group women suffering from uterovaginal prolapse, abdominal sacrohysteropexy is safe and effective. 6 Besides achieving durable anatomical restoration and normal vaginal axis, sexual function is also maintained by this procedure with excellent success rate and minimal complications.…”

Section: Introductionmentioning

confidence: 99%

Abdominal sacrohysteropexy UV prolapse and preservation of reproduction.

Ali

Ehsan

Niaz

et al. 2021

TPMJ

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Objectives: The purpose of this study was to assess the safety of sacrohystcopxy by determining intraoperative and post-operative complications and its effectiveness by pelvic organ prolapse recurrence on follow up. Study Design: Prospective study. Setting: Department of Gynecology and Obstetrics Unit-II DHQ Hospital PMC, Faisalabad. Period: Jan-2014 to Jan-2017. Material & Methods: Patients with uterovaginal prolapse, admitted through OPD were selected for abdominal sacrohysteropexy. Variables of study including duration of surgery, any intra-operative and post operative complications, need of intra operative blood transfusion, post operative hospital stay; recurrence of POP, number of pregnancies in 06 moths follow up were recorded. Results: During this study period, 319 patients were admitted with uterovaginal prolapse. 32 (10.03%) cases were selected for abdominal sacrohysteropexy. In these 32 patients, 03 (9.37%) were <30years of age, 21(65.62%) were between 30-35 years and 8 (25%) were between 35-40 years of age. About 2(6.25%) were unmarried, while 30(93.7%) were married. In these married women 14(43.75%) were multiparas, another 14(43.75%) were para 1 or 2, while 4(12.5%) were para 3 or more. Duration of surgery was 40-45 minutes in 31(96.87%) patients. In 28(87.5%) cases per operative blood loss was <150ml while in 4(12.5%) it was estimated to be >150ml but less than 300ml. Post operatively only 1(3.12%) case developed wound sepsis and it was the only one (3.12%) who was discharged on 7th post operative day, while rest 31(96.87%) were discharged on 3rd post operative day. No recurrence was noticed in 06 moths follow up, while 2(6.25%) patients became pregnant. Conclusion: Abdominal sacrohysteropexy is a safe and an effective treatment in terms of overall anatomical and functional outcome, complications, post operative recovery, length of hospital stay and sexual functioning, in women who desire uterine and hence fertility preservation.

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Vaginal Vault Suspension at Hysterectomy for Prolapse – Myths and Facts, Anatomical Requirements, Fixation Techniques, Documentation and Cost Accounting

Cited by 9 publications

References 15 publications

Value of Rectus Sheath Suspension of Vaginal Vault in Total Abdominal Hysterectomy

Value of Rectus Sheath Suspension of Vaginal Vault in Total Abdominal Hysterectomy

Double-layered anterior colporrhaphy (DAC)—video and mid-term follow-up of 60 patients

Abdominal sacrohysteropexy UV prolapse and preservation of reproduction.

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