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Vaginal vault prolapse

Michele Carlo Schiavi, Delia Savone, Daniele Di Mascio, Chiara Di Tucci, Giorgia Perniola, Marzio Angelo Zullo, Ludovico Muzii, Pierluigi Benedetti Panici
OBJECTIVES: The aim of this study was to evaluate the effectiveness of modified McCall culdoplasty or Shull suspension in preventing vaginal vault prolapse after vaginal hysterectomy and the long-term impact on quality of life and sexual function. STUDY DESIGN: Retrospective analysis in 414 patients underwent vaginal hysterectomy for pelvic organ prolapse (POP) and vaginal suspension through modified McCall culdoplasty (group A) or Shull suspension (group B) was evaluated...
February 27, 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Chunbo Li, Zhiyuan Dai, Huimin Shu
BACKGROUND: Pelvic organ prolapse (POP) is a common health problem. The lifetime risk of undergoing surgery for prolapse is 11%. POP significantly affects the effects on quality of life and activities of daily living. Laparoscopic sacrocolpopexy (LSC) has been viewed as the gold standard treatment for women with POP who desire reconstructive surgery. However, LSC is associated with technical difficulties, resulting in a long learning curve and operative time. Recently, our team introduced a new laparoscopic technique of inguinal ligament suspension (LILS) and had confirmed its safety and efficacy in treating vaginal vault prolapse...
March 5, 2018: Trials
Masao Ichikawa, Hanako Kaseki, Shigeo Akira
Laparoscopic sacrocolpopexy (LSC) is attracting increasing attention as a minimally invasive surgery that provides excellent therapeutic effects on apical vaginal prolapse. However, its therapeutic effects on multi-compartmental pelvic organ prolapse (POP) remain unclear. Therefore, the aim of this review was to evaluate the efficacy of LSC on multi-compartmental POP compared with abdominal sacrocolpopexy (ASC). We extracted three articles on randomized controlled trials that compared LSC and ASC. A total of 247 patients (123 for LSC, 124 for ASC) were evaluated...
February 2018: Asian Journal of Endoscopic Surgery
Sarah Bradley, Robert E Gutman, Lee A Richter
PURPOSE OF REVIEW: Women have an estimated 12.6% lifetime risk of undergoing surgery for pelvic organ prolapse in the USA (Wu et al. in Obstet Gynecol 123(6): 1201-6, 2014). Surgical repair of uterovaginal prolapse most commonly includes hysterectomy and vaginal vault suspension; however, the value of concomitant hysterectomy is uncertain, and there appears to be growing interest in uterine conservation. Multiple procedures have evolved using a variety of approaches. The aim of this paper is to review uterine sparing (hysteropexy) prolapse repair techniques and outcomes...
February 23, 2018: Current Urology Reports
Qinyi Zhu, Huimin Shu, Guiqiang Du, Zhiyuan Dai
BACKGROUND: Pelvic organ prolapse (POP) is a common disease in women. The aim of this research was to evaluate the safety, efficacy and complication of transvaginal modified sacrospinous ligament fixation with mesh using for the treatment of vaginal vault prolapse. MATERIALS AND METHODS: This was a prospective study including information from 60 symptomatic women with anterior-apical pelvic floor prolapse. The patients underwent transvaginal modified sacrospinous ligament fixation combined with anterior vaginal wall mesh between May 2014 and Sep 2015...
February 16, 2018: International Journal of Surgery
Yisong Chen, Junwei Li, Keqin Hua
STUDY OBJECTIVE: To describe new technique of pelvic reconstruction with Y-shaped mesh assisted by transvaginal single-port laparoscopy for multiple compartments Pelvic Organ Prolapse (POP). DESIGN: Step-by-step explanation of the procedure using video. SETTING: It is more and more prudent for pelvic floor reconstruction with mesh because of mesh related complications. Learning from sacrocolpopexy with lower rate of mesh erosion (3.5%), new method of pelvic reconstruction with natural orifice transluminal endoscopic surgery is feasible...
February 9, 2018: Journal of Minimally Invasive Gynecology
Rebecca G Rogers, Tracy L Nolen, Alison C Weidner, Holly E Richter, J Eric Jelovsek, Jonathan P Shepherd, Heidi S Harvie, Linda Brubaker, Shawn A Menefee, Deborah Myers, Yvonne Hsu, Joseph I Schaffer, Dennis Wallace, Susan F Meikle
OBJECTIVE: To retrospectively compare surgical success and complications between vaginal vault prolapse compared with uterovaginal prolapse in women who underwent apical prolapse repair for stage II-IV prolapse. METHODS: Women in one of three Pelvic Floor Disorders Network prolapse surgical trials were included. Absence of bothersome bulge symptoms, no prolapse beyond the hymen, and no subsequent prolapse treatment defined success and was our primary outcome. Secondary outcomes included comparison of quality-of-life measures, anatomic changes, and adverse events...
March 2018: Obstetrics and Gynecology
Rodolfo Milani, Matteo Frigerio, Francesca L Vellucci, Stefania Palmieri, Federico Spelzini, Stefano Manodoro
BACKGROUND: Post-hysterectomy vaginal vault prolapse repair is a challenge for pelvic floor surgeons. Native-tissue repair procedures imply lower costs and reduced morbidity. Our study aims to evaluate operative data, complications, objective, subjective and functional outcomes of transvaginal native-tissue repair for post-hysterectomy vaginal vault prolapse. We also investigated differences among available techniques. METHODS: Retrospective study including patients with symptomatic vaginal vault prolapse (≥ stage 2), previously treated with transvaginal vault suspension through native-tissue repair...
January 26, 2018: Minerva Ginecologica
Philippe E Zimmern, Connie N Wang
INTRODUCTION: Most case series describing surgical repair for pelvic organ prolapse (POP) after radical cystectomy (RC) focus on transvaginal repairs. We present our experience of POP after RC repaired by abdominal mesh sacrocolpopexy (ASC) with long-term follow-up. METHODS: Two women with previous RC with ileal conduit diversion underwent open ASC for repair of apical prolapse with concomitant enterocele. Prolapse severity was assessed using the POP quantification staging system, whereas pelvic imaging was performed with magnetic resonance imaging defecography...
January 24, 2018: Female Pelvic Medicine & Reconstructive Surgery
Stefano Restaino, Carlo Ronsini, Angelo Finelli, Alessandro Santarelli, Giovanni Scambia, Francesco Fanfani
Study Objective To prove the feasibility of Shull technique by a laparoscopy approach in patient affected by pelvic organ prolapse (POP) with apical loss of support. Design A step-by-step demonstration of the technique in a surgical video, including the fundamental steps for a laparoscopic uterosacral ligament suspension (USLS) (Canadian Task Force Classification III). Setting According to the National Health and Nutrition Examination Survey, approximately 3% of women in the United States report symptoms linked to POP...
December 28, 2017: Journal of Minimally Invasive Gynecology
Rodolfo Milani, Stefano Manodoro, Alice Cola, Stefania Palmieri, Matteo Frigerio
INTRODUCTION AND HYPOTHESIS: Posthysterectomy vaginal vault prolapse repair represents a surgical challenge. Surgical management can be successfully achieved with native-tissue repair through levator myorrhaphy. Despite low morbidity, levator myorrhaphy is not a common procedure. The aim of the video is to provide anatomic views and surgical steps necessary to achieve a successful transvaginal levator myorrhaphy for vaginal vault prolapse repair. METHODS: A 72-year-old woman with symptomatic stage IV vaginal vault prolapse was admitted for transvaginal levator myorrhaphy according to the described technique...
December 14, 2017: International Urogynecology Journal
Sunesh Kumar, Seema Singhal, Yamini Kansal, Dayanand Sharma
Vaginal Cuff Dehiscence (VCD) is partial or total separation of anterior and posterior vaginal cuff layers. We report a case of recurrent vault cuff dehiscence in a patient of cervical carcinoma. A 60-year-old treated case of carcinoma cervix post surgery and radiotherapy was found to have vault dehiscence and intestinal prolapse second time during a routine speculum examination. She underwent an emergency laparotomy and closure of vault. Vaginal Cuff Dehiscence with Evisceration (VCDE) is a rare but potentially fatal complication following hysterectomy...
September 2017: Journal of Clinical and Diagnostic Research: JCDR
Dudley Robinson, Gans Thiagamoorthy, Linda Cardozo
Post-hysterectomy vaginal vault prolapse (PHVP) is a recognised although rare complication following both abdominal and vaginal hysterectomy and the risk is increased in women following vaginal surgery for urogenital prolapse. The management of PHVP remains challenging and whilst many women will initially benefit from conservative measures, the majority will ultimately require surgery. The purpose of this paper is to review the prevalence and risk factors associated with PHVP as well to give an overview of the clinical management of this often complicated problem...
January 2018: Maturitas
Seethalakshmi Krishnan
Background: To assess the quality of life in geriatric patients after reconstructive and obliterative vaginal surgery for advanced pelvic organ prolapse (POP). Methods: Prospective observational study was conducted between January 2009 and December 2014 at the department of Urogynaecology, Government Kasturbha Gandhi Hospital. A total of 424 women (between the age group of 60 and 94 years) with advanced pelvic organ prolapse underwent vaginal hysterectomy along with vaginal apical suspension procedures which were McCalls culdoplasty (35...
December 2017: Journal of Obstetrics and Gynaecology of India
Yisong Chen, Junwei Li, Ying Zhang, Keqin Hua
STUDY OBJECTIVE: More and more patients are pursuing minimally invasive surgery, which is becoming the trend for gynecologic surgery today. Pelvic organ prolapse (POP) is no exception. With the application of natural orifice transluminal endoscopic surgery, minimally invasive transvaginal sacrocolpopexy surgery assisted by single-port laparoendoscopy for POP becomes feasible. Here we describe our technique of transvaginal sacrocolpopexy using single-port laparoscopy for middle compartment POP...
November 22, 2017: Journal of Minimally Invasive Gynecology
Anne-Lotte W M Coolen, Bich Ngoc Bui, Viviane Dietz, Rui Wang, Aafke P A van Montfoort, Ben Willem J Mol, Jan-Paul W R Roovers, Marlies Y Bongers
INTRODUCTION AND HYPOTHESIS: The treatment of post-hysterectomy vaginal vault prolapse (VVP) has been investigated in several randomized clinical trials (RCTs), but a systematic review of the topic is still lacking. The aim of this study is to compare the effectiveness of treatments for VVP. METHODS: We performed a systematic review and meta-analysis of the literature on the treatment of VVP found in PubMed and Embase. Reference lists of identified relevant articles were checked for additional articles...
December 2017: International Urogynecology Journal
Stefano Manodoro, Matteo Frigerio, Rodolfo Milani, Federico Spelzini
INTRODUCTION AND HYPOTHESIS: Uterosacral ligament (USL) suspension is an effective and versatile surgical technique for repairing pelvic organ prolapse. However, ureteral injury is a feared complication that may act as a significant deterrent to the use of USL suspension. The aim of the video is to provide key steps to minimize the risk of ureteral injury while achieving successful transvaginal USL suspension. METHODS: The featured video provides a series of surgical tips and tricks that can be applied to protect the ureters while achieving USL suspension whether the procedure contemplated is vaginal hysterectomy, vaginal vault repair after hysterectomy, or hysteropexy...
October 16, 2017: International Urogynecology Journal
M Nováčková, Z Pastor, T Brtnický, R Chmel
OBJECTIVE: To determine the risk of prolapse recurrence in patients after vaginal hysterectomy with colporrhaphy. DESIGN: Retrospective clinical study. SETTING: Department of Obstetrics and Gynaecology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague. METHODS: The trial involved 220 women who underwent vaginal hysterectomy with anterior and posterior kolporrhaphy at our department for uterine prolapse at least grade 2...
2017: Ceská Gynekologie
Jennifer Campbell, Corinne Pedroletti, Linn Ekhed, Emil Nüssler, Annika Strandell
INTRODUCTION AND HYPOTHESIS: Innovations in suturing devices have facilitated sacrospinous ligament fixation (SSF) for the correction of vaginal vault prolapse. It is uncertain if outcomes using suturing devices differ from those using a traditional suturing technique. We hypothesize that no difference exists in the efficacy and safety 1 year after SSF for vault prolapse performed with suturing devices or using a traditional technique. The objective was to compare SSF using a suturing device with traditional SSF for the treatment of vault prolapse, regarding symptoms of prolapse recurrence, patient satisfaction, incidence of re-operation, and complications 1 year postoperatively...
October 7, 2017: International Urogynecology Journal
Swati Jha, Alfred Cutner, Paul Moran
INTRODUCTION AND HYPOTHESIS: To assess trends in the surgical management of pelvic organ prolapse (POP) amongst UK practitioners and changes in practice since a previous similar survey. METHODS: An online questionnaire survey (Typeform Pro) was emailed to British Society of Urogynaecology (BSUG) members. They included urogynaecologists working in tertiary centres, gynaecologists with a designated special interest in urogynaecology and general gynaecologists. The questionnaire included case scenarios encompassing contentious issues in the surgical management of POP and was a revised version of the questionnaire used in the previous surveys...
September 15, 2017: International Urogynecology Journal
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