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Erschienen in:
21.04.2020 | IUJ Video
Video of uterovaginal procidentia repair incorporating a high extraperitoneal uterosacral vault suspension
Erschienen in: International Urogynecology Journal | Ausgabe 10/2020
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Introduction and hypothesis
Women with high-grade uterovaginal prolapse have a higher incidence of levator injury, larger levator hiatal defects, and are at a greater risk of recurrent prolapse after pelvic organ prolapse (POP) surgery. RCOG guidelines have recommended prophylactic sacrospinous suspension at the time of vaginal hysterectomy, whenever there is a marked uterovaginal prolapse. The aim of the video is to describe our surgical approach at the time of surgery for advanced POP, and describe the technique for modified McCall high extraperitoneal vault suspension.
Methods
We have modified the McCall culdoplasty by extending the dissection of the middle portion of the uterosacral/cardinal ligaments so that the sutures can be placed higher and more laterally extraperitoneally to re-support the vaginal cuff at the time of a vaginal hysterectomy.
Results
The video highlights the surgical technique used for apical support at the time of surgery for advanced POP.
Conclusions
This video demonstrates our modified McCall technique for vault suspension at the time of vaginal surgery for advanced POP. This technique could be considered an alternative technique to other modes of apical support.