Anatomie aspects of vaginal eversion after hysterectomy

DeLancey, John O.L.

doi:10.1016/0002-9378(92)91562-o

Cited by 899 publications

(509 citation statements)

References 12 publications

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“…Level I cardinal-uterosacral ligaments providing apical support, level II arcus tendineus fascia pelvis supporting middle part of vagina laterally and level III urogenital diaphragm and perineal body supporting lower part of the vagina [45]. The contribution of each of these structures to occurrence of prolapse as we see it in the clinic, is not well defined.…”

Section: The Failure Of Ppl In the Pelvic Floormentioning

confidence: 87%

Synthetic Materials Used in the Surgical Treatment of Pelvic Organ Prolapse: Problems of Currently Used Material and Designing the Ideal Material

Mangır¹,

Chapple²,

MacNeil³

2018

Pelvic Floor Disorders

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Synthetic materials have long been used to provide structural support when surgically repairing pelvic organ prolapse (POP). The most widely used synthetic material is a mesh made of polypropylene (PPL). The use of mesh is intended to improve cure rates and prevent recurrences after POP surgery -however as more mesh materials have been implanted, it has become apparent that serious complications can occur in up to 30% of women, particularly when the mesh is implanted transvaginally. Over the years many different mesh kits have been marketed and used in the treatment of POP however polypropylene mesh was never designed or tested for use in pelvic floor. Instead it was approved for clinical use based on its biocompatibility and success in abdominal hernia repairs. It is now known that PPL meshes are neither compliant with the mechanical forces in the pelvic floor nor do they integrate well into paravaginal tissues. Better materials developed specifically for use in pelvic floor are urgently needed. The aim of this chapter is to define the requirements of an ideal mesh in terms of its material properties and to summarize the ongoing research on developing the next generation pelvic floor repair materials.

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Section: The Failure Of Ppl In the Pelvic Floormentioning

confidence: 87%

Synthetic Materials Used in the Surgical Treatment of Pelvic Organ Prolapse: Problems of Currently Used Material and Designing the Ideal Material

Mangır¹,

Chapple²,

MacNeil³

2018

Pelvic Floor Disorders

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“…The three levels of connective tissue structures that provide vaginal support are generally acknowledged to be the cardinal/uterosacral ligament complex (superior attachment), the superolateral insertion points of the anterior vaginal wall, the rectovaginal fascia (lateral attachment), the perineal body, and the perineal membrane (distal attachment) [4]. This procedure provides reconstruction at the three levels of connective tissue support [2].…”

Section: Discussionmentioning

confidence: 99%

“…The aim of the technique is to repair the three levels of vaginal support described by De Lancey [4].…”

Section: Operative Techniquementioning

confidence: 99%

Posterior intravaginal slingplasty for vault and uterovaginal prolapse: an initial experience

2006

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Genital prolapse surgeries are traditionally timeconsuming and can be complex with significant morbidity. Most of the techniques described have incorporated removal of the prolapsed uterus prior to the repair, thus increasing morbidity and hospital stay. Recently, interest has been focused on minimally invasive day-case techniques, which have similar success rates but relatively lower morbidity than the conventional surgeries. We report an initial experience of 14 cases of vault and uterovaginal prolapse treated with the intravaginal slingplasty procedure. This study involved retrospective analyses of the case notes as well as evaluation by contemporary patient questionnaire. In our series we used a modified technique to correct uterovaginal prolapse without performing a hysterectomy. The cure rates in vault and uterovaginal prolapses were statistically significant, and the complication rates were minimal, facilitating a short hospital stay. Hence, the procedure was equally successful in women who had undergone hysterectomy and women with an intact uterus. We conclude that intravaginal slingplasty is minimally invasive and safe, with a high cure rate and high patient satisfaction.

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“…43). 18 Refinement of previous classification [49] reflecting the average length of non-gravid uterine cervix [50] and the average length of the supportive influence of the distal segment of the uterosacral ligaments on the posterolateral vaginal wall bilaterally [51] . .…”

Section: Appendix -Concepts and Available Measurements Awaiting Furthmentioning

confidence: 99%

Erratum to: An International Urogynecological Association (IUGA) / International Continence Society (ICS) joint report on the terminology for female pelvic organ prolapse (POP)

et al. 2016

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Anatomie aspects of vaginal eversion after hysterectomy

Cited by 899 publications

References 12 publications

Synthetic Materials Used in the Surgical Treatment of Pelvic Organ Prolapse: Problems of Currently Used Material and Designing the Ideal Material

Synthetic Materials Used in the Surgical Treatment of Pelvic Organ Prolapse: Problems of Currently Used Material and Designing the Ideal Material

Posterior intravaginal slingplasty for vault and uterovaginal prolapse: an initial experience

Erratum to: An International Urogynecological Association (IUGA) / International Continence Society (ICS) joint report on the terminology for female pelvic organ prolapse (POP)

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