Skip to main content
Top
Published in: International Urogynecology Journal 7/2012

01-07-2012 | Original Article

A preliminary anatomical basis for dual (uterosacral and sacrospinous ligaments) vaginal vault support at colporrhaphy

Dual-balanced vaginal vault support at colporrhaphy

Authors: Bernard T. Haylen, Dzung Vu, Warwick Birrell, Stas Vashevnik, Kelly Tse

Published in: International Urogynecology Journal | Issue 7/2012

Login to get access

Abstract

Introduction and hypothesis

This study aims to assess anatomically the likely effects of dual vaginal vault support using the uterosacral (USL) and sacrospinous ligaments (SSL) at colporrhaphy.

Methods

Observations were made from 13 formalinized cadaver hemipelves to determine the vaginal vault support likely to be provided by traction on the (a) USLs and (b) the posterior vaginal vault towards the SSL.

Results

Traction on the USLs and SSLs both appeared to create a posterior and superior vector of vaginal vault tension, though that on the USLs appeared to be mainly on the anterior vaginal vault (and wall) with that on the SSL seemingly mostly on the posterior vaginal vault (and wall).

Conclusions

Concomitant USL and SSL traction on the vaginal vault, now technically possible, appears, from these preliminary findings, to give complementary support to the anterior and posterior aspects of the vaginal vault and walls in a similar posterior and superior vector.
Literature
1.
go back to reference Dwyer PL, Fatton B (2008) Bilateral extraperitoneal uterosacral suspension: a new approach to correct posthysterectomy vaginal vault prolapse. Int Urogynecol J 19:283–292CrossRef Dwyer PL, Fatton B (2008) Bilateral extraperitoneal uterosacral suspension: a new approach to correct posthysterectomy vaginal vault prolapse. Int Urogynecol J 19:283–292CrossRef
2.
go back to reference Haylen BT, de Ridder D, Freeman RM, Swift SE, Berghmans B, Lee J, Monga A, Petri E, Rizk D, Sand PK, Schaer GK (2010) An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Neurourol Urodyn 29:4–20 and Int Urogynecol J, 21:5–26 Haylen BT, de Ridder D, Freeman RM, Swift SE, Berghmans B, Lee J, Monga A, Petri E, Rizk D, Sand PK, Schaer GK (2010) An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Neurourol Urodyn 29:4–20 and Int Urogynecol J, 21:5–26
3.
go back to reference Bump RC, Mattiasson A, Bo K, Brubaker LP et al (1996) The standardization of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol 175(1):10–11PubMedCrossRef Bump RC, Mattiasson A, Bo K, Brubaker LP et al (1996) The standardization of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol 175(1):10–11PubMedCrossRef
4.
go back to reference Holley RL, Varner RE, Gleason BP, Apffel LA, Scott S (1995) Recurrent pelvic support defects after sacrospinous ligament fixation for vaginal vault prolapse. J Am Coll Surg 180:444–448PubMed Holley RL, Varner RE, Gleason BP, Apffel LA, Scott S (1995) Recurrent pelvic support defects after sacrospinous ligament fixation for vaginal vault prolapse. J Am Coll Surg 180:444–448PubMed
5.
go back to reference Haylen BT, Wang V, Vu D, Tse K (2011) Midline uterosacral plication anterior colporrhaphy combo (MUSPACC): preliminary report. Int Urogynecol J 22:69–75PubMedCrossRef Haylen BT, Wang V, Vu D, Tse K (2011) Midline uterosacral plication anterior colporrhaphy combo (MUSPACC): preliminary report. Int Urogynecol J 22:69–75PubMedCrossRef
6.
go back to reference Vu D, Haylen BT, Tse K, Farnswoth A (2010) Surgical anatomy of the uterosacral ligament. Int Urogynecol J 21:1123–1128PubMedCrossRef Vu D, Haylen BT, Tse K, Farnswoth A (2010) Surgical anatomy of the uterosacral ligament. Int Urogynecol J 21:1123–1128PubMedCrossRef
7.
go back to reference Barber MD, Visco AG, Weidner AC, Amundsen CL, Bump RC (2000) Bilteral uterosacral ligament vaginal vault suspension with site-specific endopelvic fascia defect repair for treatment of pelvic organ prolapse. Am J Obstet Gynecol 183:1402–1410PubMedCrossRef Barber MD, Visco AG, Weidner AC, Amundsen CL, Bump RC (2000) Bilteral uterosacral ligament vaginal vault suspension with site-specific endopelvic fascia defect repair for treatment of pelvic organ prolapse. Am J Obstet Gynecol 183:1402–1410PubMedCrossRef
8.
go back to reference Shull BL, Bachofen C, Coates KW, Kuehl TJ (2000) A transvaginal approach to repair of apical and other associated sites of pelvic organ prolapse with uterosacral ligaments. Am J Obstet Gynecol 183:1365–1373PubMedCrossRef Shull BL, Bachofen C, Coates KW, Kuehl TJ (2000) A transvaginal approach to repair of apical and other associated sites of pelvic organ prolapse with uterosacral ligaments. Am J Obstet Gynecol 183:1365–1373PubMedCrossRef
9.
go back to reference Karram M, Goldwasser S, Kleeman S, Steele A, Vassallo B, Walsh P (2001) High uterosacral vaginal vault suspension with fascial reconstruction for vaginal repair of enterocoele and vaginal vault prolapse. Am J Obstet Gynecol 185:1339–1343PubMedCrossRef Karram M, Goldwasser S, Kleeman S, Steele A, Vassallo B, Walsh P (2001) High uterosacral vaginal vault suspension with fascial reconstruction for vaginal repair of enterocoele and vaginal vault prolapse. Am J Obstet Gynecol 185:1339–1343PubMedCrossRef
Metadata
Title
A preliminary anatomical basis for dual (uterosacral and sacrospinous ligaments) vaginal vault support at colporrhaphy
Dual-balanced vaginal vault support at colporrhaphy
Authors
Bernard T. Haylen
Dzung Vu
Warwick Birrell
Stas Vashevnik
Kelly Tse
Publication date
01-07-2012
Publisher
Springer-Verlag
Published in
International Urogynecology Journal / Issue 7/2012
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-011-1633-7

Other articles of this Issue 7/2012

International Urogynecology Journal 7/2012 Go to the issue