Abdominal sacral colpopexy in the management of vaginal vault prolapse: technique and two-year follow-up.The abdominal sacral sacral /sa·cral/ (sa´kral) pertaining to the sacrum. sa·cral adj. In the region of or relating to the sacrum. sacral, adj pertaining to the sacrum. colpopexy offers the following advantages, consistent anatomy, most definitive enterocele repair and culdoplasty. We describe the surgical technique of colpopexy, and present post-operative results in patients with at least 18 months of follow-up. Forty women with vault prolapse prolapse Protrusion of an internal organ out of its normal place, usually of the rectum or uterus outside the body when supporting muscles weaken. The membrane lining the rectum can push out through the anus, most often in old people with constipation who strain during underwent abdominal sacral colpopexy, Halban culdoplasty, and anti-incontinence surgery, if indicated. Prior to surgical procedure, all patients had prolapse of the vaginal cuff vaginal cuff Gynecology The part of the vagina remaining after hysterectomy and cervicectomy beyond the introitus. The surgical technique will be illuminated in detail. Follow-up consisted of pelvic examination A pelvic examination, also pelvic exam, is a physical examination of the female pelvic organs. Broadly, it can be divided into the external examination and internal examination. and assessment of patient satisfaction every 6 months. Prolapse "half-way" to the introitus (Grade II) or greater was considered "significant prolapse." Surgical failure was identified as grade III prolapse or greater. Satisfaction was assessed on a scale of 1-3, with 3 being "highly satisfied." Patients also revealed if they perceived the surgery as successful or not. Forty patients had an average age of 66.5 (48-81) years. The average follow-up is 25.5 (18-42) months; 22 of 40 (55%) patients did not have significant prolapse: 14 patients had no prolapse, and 8 patients had a grade I cystocele and/or rectocele rectocele /rec·to·cele/ (rek´to-sel) hernial protrusion of part of the rectum into the vagina. rec·to·cele n. See proctocele. ; 18 of 40 (45%) patients did have "significant prolapse": 8 recurrent cystoceles (4 grade II/4 grade III), 6 recurrent rectoceles (2 grade II/4 grade III), and 3 had both a grade II cystocele and rectocele. There was 1 case of recurrent vault prolapse; 8 of 40 (20%) were considered surgical failures. The patients with no prolapse post-operatively were highly satisfied (average score 2.95), and 100% considered the surgery successful. The recurrent prolapse group was less satisfied (average score 2.5), and 66.7% considered the surgery successful. The abdominal sacral colpopexy is an effective and durable method of correction of vaginal vault prolapse. Recurrent pelvic organ prolapse is not an uncommon finding after colpopexy, however, these defects are usually asymptomatic a·symp·to·mat·ic adj. Exhibiting or producing no symptoms. Asymptomatic Persons who carry a disease and are usually capable of transmitting the disease but, who do not exhibit symptoms of the disease are said to be and satisfaction remains high. Kristie M. Blanchard, MD, and J. Christian Winters, MD. New Orleans New Orleans (ôr`lēənz –lənz, ôrlēnz`), city (2006 pop. 187,525), coextensive with Orleans parish, SE La., between the Mississippi River and Lake Pontchartrain, 107 mi (172 km) by water from the river mouth; founded , LA. |
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