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Transvaginal sacrospinous ligament fixation for posthysterectomy vaginal vault prolapse repair.

Abstract：

INTRODUCTION AND HYPOTHESIS:Posthysterectomy vaginal vault prolapse repair is a challenge for urogynecologists. Surgical management can be successful with native tissue by the vaginal approach with sacrospinous ligament fixation. However, severe complications have been described, including nerve injury and life-threatening hemorrhage. METHODS:A 68-year-old woman with symptomatic stage III vaginal vault prolapse was admitted for transvaginal sacrospinous ligament fixation according to the described technique. RESULTS:The surgical procedure was successful without complications. The final examination revealed excellent apical support and preservation of vaginal length. This step-by-step video tutorial may be an important tool for improving surgical knowledge, thus leading to a reduction in the risk of complications. In particular proper suture positioning requires adequate preparation of the pararectal space and exposure of the sacrospinous ligament, as shown in the video. CONCLUSIONS:Transvaginal sacrospinous ligament fixation is a safe and effective technique for apical support without the use of prosthetic materials. Adequate preparation of the pararectal space, direct visualization of the sacrospinous ligament and proper suture positioning are the key points in minimizing the risk of complications.

journal_name

Int Urogynecol J

journal_title

International urogynecology journal

authors

Milani R,Frigerio M,Manodoro S

doi

10.1007/s00192-016-3255-6

subject

Has Abstract

pub_date

2017-07-01 00:00:00

pages

1103-1105

issue

7

eissn

0937-3462

issn

1433-3023

pii

10.1007/s00192-016-3255-6

journal_volume

28

pub_type

杂志文章

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