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International Urogynecology Journal

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01-09-2017 | IUJ Video

Transvaginal uterosacral ligament suspension for posthysterectomy vaginal vault prolapse repair

Authors: Rodolfo Milani, Matteo Frigerio, Federico Spelzini, Stefano Manodoro

Published in: International Urogynecology Journal | Issue 9/2017

Abstract

Introduction and hypothesis

Posthysterectomy vaginal vault prolapse repair represents a challenge for urogynecologists. Surgical management can be successfully achieved with native tissue using a vaginal approach with uterosacral ligament (USL) suspension. However, severe complications have been described, mainly related to ureteral injury.

Methods

A 57-year-old woman with symptomatic stage 2 vaginal vault prolapse underwent transvaginal USL suspension according to the described technique.

Results

Surgical procedure was successfully achieved without complications. Final examination revealed excellent apical support and preservation of vaginal length. However, ureteral damage represents the major pitfall of USL suspension. This step-by-step video tutorial may represent an important tool to improve surgical know how and minimize the risk of ureteral injury.

Conclusion

Transvaginal USL suspension provides an effective technique for apical support without the use of prosthetic materials. Intimate understanding of pelvic anatomy, direct visualization of ureter, and proper suture positioning are the key points to minimize the risk of complications.

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Title: Transvaginal uterosacral ligament suspension for posthysterectomy vaginal vault prolapse repair
Authors: Rodolfo Milani
Matteo Frigerio
Federico Spelzini
Stefano Manodoro
Publication date: 01-09-2017
Publisher: Springer London
Published in: International Urogynecology Journal / Issue 9/2017
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-017-3277-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Transvaginal uterosacral ligament suspension for posthysterectomy vaginal vault prolapse repair

Abstract

Introduction and hypothesis

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction and hypothesis

Methods

Results

Conclusion

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