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Vaginal Hysterectomy for the Prolapsed Uterus

LUCERO, MONICA MD, MPH; SHAH, APARNA D. MD

Clinical Obstetrics & Gynecology: March 2010 - Volume 53 - Issue 1 - pp 26-39
doi: 10.1097/GRF.0b013e3181cd4065
Vaginal Surgery

Although most gynecologists are comfortable performing vaginal hysterectomy in the patient without significant uterovaginal prolapse, vaginal hysterectomy for the prolapsed uterus poses unique challenges and requires an increased awareness of deviations in pelvic anatomy that may result. This review article discusses the background of vaginal hysterectomy performed for uterovaginal prolapse, the pathophysiology of uterovaginal prolapse, preoperative assessment of the patient with uterovaginal prolapse, surgical technique, ureteral anatomy, techniques to avoid injury to the ureter at the time of vaginal hysterectomy for uterovaginal prolapse, and other relevant considerations.

UMass Medical School, Department of Obstetrics and Gynecology, Division of Urogynecology, Worcester, Massachusetts

Correspondence: Aparna D. Shah, MD, UMass Medical School, Department of Obstetrics and Gynecology, Division of Urogynecology, Worcester, MA. E-mail: AparnaDiwan.Shah@umassmemorial.org

© 2010 Lippincott Williams & Wilkins, Inc.