Repair of prolapse with vaginal sacrocolporectopexy: Technique and results

Selective embolization of the superior vesical artery for the treatment of a severe retroperitoneal pelvic haemorrhage following Endo-Stitch sacrospinous colpopexy

“…Transvaginal SSL fixation has a 0.5-1% incidence of severe vascular injuries [2,3]. Several different venous and arterial hemorrhages have been described [2,3].…”

“…Several different venous and arterial hemorrhages have been described [2,3]. The inferior gluteal vessels are those most likely injured vessels [5], but others include the pudendal artery, the coccygeal branches of the inferior gluteal artery [12], the sacral veins [3], and arterial anastomoses or anomalous vessels adjacent to the posterior aspect of to the SSL [12,13].…”

“…Despite its numerous advantages derived from the minimally invasive approach [1], complications can be present in up to 41% of cases and include bladder injuries (3.6%), rectal injuries (1.7%), uretero-vaginal fistulas (0.5%), vascular injuries (0.5-1%), and thromboembolic events (0.5%) [2][3][4]. Vascular injuries are among the most dangerous complications and usually involve the inferior gluteal artery and the pudendal artery [5].…”

Retentissement de la chirurgie du prolapsus génital sur la sexualité des patientes

“…Parmi les é tudes prospectives sur la ré paration chirurgicale vaginale, six [14][15][16][17][18][19] dé crivent une amé lioration significative aprè s chirurgie mais seulement trois utilisent des questionnaires validé s. Cinq auteurs ne trouvent pas de modification de la sexualité aprè s chirurgie vaginale [20][21][22][23][24] dont trois avec des questionnaires validé s. Trois é tudes [25,7,26] retrouvent une possible aggravation. Cette aggravation ne semble pas corré lé e à la diminution des dimensions vaginales même s'il existe une ré duction significative de la taille du vagin en postopé ratoire [26].…”

Postoperative anatomic and quality‐of‐life outcomes after vaginal sacrocolporectopexy for vaginal vault prolapse

“…During this procedure, the vaginal apex and the rectum are fixed with a monofilament suture to the anterior longitudinal ligament of the sacral os. Two pilot studies have provided promising results about the safety and favorable perioperative outcome of vaginal sacrocolporectopexy. Indeed, mesh‐free vaginal approaches represent a valuable method for POP surgery, which avoids the occurrence of rare severe adverse effects associated with the early generations of mesh implants, as well as the prolonged operative and recovery times of abdominal approaches …”