Objective: This study aims to describe a new surgical technique to prevent ureteral kinking via dissection uterosacral ligament from parietal peritoneum before McCall culdoplasty suture placement, and vaginal cuff fixation to round ligament to prevent apical vaginal vault prolapse after vaginal hysterectomy.  Materials and Methods: At the initial step of vaginal hysterectomy, a circumferential incision was done on vaginal tissue, which covers the uterine cervix. Then posterior cul-de-sac was entered. Bilateral uterosacral ligament was identified, separately clamped, cut and sutured. Classical vaginal hysterectomy was completed up to the round ligament, which was separately grasped, cut and sutured. After the vaginal hysterectomy, the uterosacral ligament dissected from cardinal ligament and parietal peritoneum to prevent ureteral kinking during McCall Culdoplasty suture placement. Two internal McCall sutures with non-absorbable sutures and one external suture with absorbable sutures were place on the uterosacral ligament. Then bilateral apical lateral vaginal walls were fixated to ipsilateral round ligament to further support to vaginal vault. Results: I have applied the new technique to my patients with pelvic organ prolapse for about one year. Ureteral kinking has not occurred in any patient. Early complications such as hemorrhage, bladder and ureter injury did not  observed.    Conclusion: Ureteral kinking is a challenging problem for gynecologists during suture placement on the uterosacral ligament. Dissection of the uterosacral ligament from the cardinal ligament and parietal peritoneum yielded the surgeon to safe suture passage during McCall Culdoplasty suture placement and eliminated the requirement of cystoscopy evaluation to check ureteral competency.

Objective: Placental implants in the cervical canal may occur result in patients with placenta previa that lead to bleeding after placental removal. Bleeding from the cervical canal can be stopped by inserting the Cook Ripening Balloon.     Case Presentation: A 31-week pregnant an was brought to the emergency clinic with a complaint of vaginal bleeding, and active vaginal bleeding was observed. Ultrasonography showed a fetus with fetal bradycardia and placenta previa. The patient  underwent emergency Caesarean delivery. The placenta was easily removed without any complications. Bleeding from the cervical canal was observed by vaginal examination. The Cook Cervical Ripening Balloon was inserted into the cervical canal, and the bleeding stopped. The patient was discharged healthy. Conclusion: Bleeding from the uterine cervix can be stopped by insertion of the Cook Cervical Ripening Balloon.