Abdominal sacral colpoperineopexy: a new approach for correction of posterior compartment defects and perineal descent associated with vaginal vault prolapse
Autor: | Robert L. Harris, Richard C. Bump, W.Allen Addison, Geoffrey W. Cundiff, Vincent H.S. Low, Kimberly W. Coates |
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Rok vydání: | 1998 |
Předmět: |
Adult
medicine.medical_specialty Hernia Uterine Prolapse Medical Illustration medicine Defecography Humans Postoperative Period Herniorrhaphy Aged medicine.diagnostic_test business.industry Suture Techniques Obstetrics and Gynecology Uterine prolapse Fascia Middle Aged Sacrum medicine.disease Perineum Surgery medicine.anatomical_structure Rectal Diseases Treatment Outcome Vagina Female business Vaginal Vault Prolapse |
Zdroj: | American journal of obstetrics and gynecology. 177(6) |
ISSN: | 0002-9378 |
Popis: | OBJECTIVE: Our purpose was to assess a modification of abdominal sacral colpopexy in 19 patients. STUDY DESIGN: The rectovaginal space was dissected to the superior aspect of the posterior vaginal fascia still contiguous with the perineal body. Mersilene (Ethicon, Somerville, N.J.) mesh was sutured to this fascia and along the entire posterior vaginal wall. Patients with vault prolapse, perineal descent, and associated rectoceles or enteroceles are reported. Outcome measures included bowel symptoms and pelvic organ prolapse staging. Defecography was performed in three patients. Wilcoxon signed rank analysis was used for comparison of prolapse measures. RESULTS: Mean follow-up was 11 weeks. Bowel symptoms improved in 8 of 11 women. No subjects had greater than stage II prolapse postoperatively and median improvement in stage was 3 (range 2 to 4). The mean decrease in the genital hiatus measurement was 3.13 ± 1.25 (range 2 to 6) cm. Postoperative defecography documented correction of rectoceles and enteroceles and improvement in perineal descent with straining. CONCLUSIONS: Abdominal sacral colpoperineopexy is effective surgery for vaginal vault prolapse associated with perineal descent and posterior vaginal defects.(Am J Obstet Gynecol 1997;177:55) |
Databáze: | OpenAIRE |
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