Postpartum Uterine Retroversion Causing Bladder Outflow Obstruction: Cure by Laparoscopic Ventrosuspension

Haylen, Bernard T.; Cerqui, Anthony J.

doi:10.1007/s001920050058

Cited by 5 publications

(3 citation statements)

References 10 publications

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“…The round ligament, as a relatively weak support to the uterus anterior to the CL and USL, can provide an indirect VV support. It can subjected to shortening (by concertina effect) as in a ventrosupension, 8 generally to antevert a retroverted uterus, connected to the VV. Figure 4 demonstrates the 3 ligaments in the one axial cadaveric section (from the Visible Human Project series).…”

Section: Vv Supports—prehysterectomymentioning

confidence: 99%

Surgical anatomy of the vaginal vault

Haylen

2022

Neurourology and Urodynamics

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Aim: Vaginal vault (VV) surgery should be a key part of surgery for a majority of pelvic organ prolapse (POP). The surgical anatomy of the VV, the upper most part of the vagina, has not been recently subject to a dedicated examination and description.Methods: Cadaver studies were performed in (i) 10 unembalmed cadaveric pelves (observation); (ii) 2 unembalmed cadaveric pelves (dissection); (iii) 5 formalinized hemipelves (dissection). The structural outline and ligamentous supports of the VV were determined. Further confirmation of observations in post-hysterectomy patients were from a separate study on 300 consecutive POP repairs, 46% of whom had undergone prior hysterectomy. Results: The VV is equivalent to the Level I section of the vagina, measured posteriorly from the top of the posterior vaginal wall (apex or highest part of the vagina) to 2.5 cm below this point. It comprises the anterior fornix (through which cervix protrudes or is removed at hysterectomy), posterior fornix and two lateral fornices. Before hysterectomy, the posterior aspects of the cervix and upper vagina are supported by the uterosacral (USL) and cardinal ligaments (CL), the distal segments of which fuse together to form a cardinal-uterosacral ligament complex (cardinal utero-sacral complex), around 2-3 cm long. Post---hysterectomy, there is some residual USL support to the anterior fornix but the posterior fornix has no ligamentous support and is thus more vulnerable to prolapse. Conclusion:Effective management of VV prolapse will need to be part of most POP repairs. Enhanced understanding of the surgical anatomy of the vaginal vault allows more effective planning of those POP surgeries.

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Section: Vv Supports—prehysterectomymentioning

confidence: 99%

Surgical anatomy of the vaginal vault

Haylen

2022

Neurourology and Urodynamics

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“…In the circumstances of a much smaller increase in the size of a retroverted uterus, particularly where uterine preservation is important, we have shown that bladder outflow obstruction can be cured with a laparoscopic ventrosuspension [6].…”

mentioning

confidence: 79%

Urinary retention secondary to a uterine leiomyoma: is it nonpregnant incarceration of a retroverted uterus?

Haylen

2007

Int Urogynecol J

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“…Until now, there has been only one citation in the urogynaecological literature [1]. There are only two other citations referencing the retroverted uterus in association with bladder dysfunction [2,3].…”

Section: Introductionmentioning

confidence: 99%

The retroverted uterus: ignored to date but core to prolapse

Haylen

2006

Int Urogynecol J

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The retroverted uterus has been largely ignored in urogynaecological research to date. The prevalence of the retroverted uterus is 79% more common in the urogynaecological patient population (34%) than in the general gynaecological population (19%). Its diagnosis requires the use of (a) transvaginal ultrasound with (b) an empty bladder. Recent data demonstrate that the prevalence of grade 2-4 uterine prolapse for a retroverted uterus is 4.5 times that for an anteverted uterus. Alternatively, 69% grade 2-4 uterine prolapse involves the retroverted uterus. The retroverted uterus, when diagnosed by transvaginal ultrasound (bladder empty), is far more common in urogynecology patients due to their higher incidence of prolapse.

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Postpartum Uterine Retroversion Causing Bladder Outflow Obstruction: Cure by Laparoscopic Ventrosuspension

Cited by 5 publications

References 10 publications

Surgical anatomy of the vaginal vault

Surgical anatomy of the vaginal vault

Urinary retention secondary to a uterine leiomyoma: is it nonpregnant incarceration of a retroverted uterus?

The retroverted uterus: ignored to date but core to prolapse

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