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Broach, A.; Lee, T.
UPMC, Magee Womens Hospital, Pittsburgh, PA
DISCLOSURE OF RELEVANT FINANCIAL RELATIONSHIPS: Ted Lee:Ethicon Endosurgery:honorarium:speaker/ consultant
To demonstrate our laparoscopic sacrohysteropexy in a nulliparous woman with stage 4 uterovaginal prolapse.
Studies have shown that uterine preservation is an option for women undergoing pelvic reconstructive surgery for uterovaginal prolapse. Several procedures have been described including the use of sutures to shorten the stretched uterosacral ligaments as well as the use of mesh to anchor the posterior cervix to the sacrum. The anterior compartment maybe left unsupported in most the techniques previously described. We present a case of a 39 year-old female with congenital muscular dystrophy who suffers from symptomatic stage 4 uterovaginal prolapse. She desired the potential for future child bearing, and therefore, wished to retain her uterus. We performed laparoscopic sacrohysteropexy, utilizing a prolene mesh. Our procedure is unique as it utilizes an avascular plane between the ascending uterine vessels and the cervix to tunnel the mesh from the sacrum to anterior cervix and vagina. This tunnel will prevent the potential compromise of uterine blood flow that could occur during a pregnancy due to the prolene mesh. With this technique, the surgeon can address anterior compartment support defect which is usually neglected in most uterine preserving prolapse repair procedures.
Concurrent anterior compartment support defect can be addressed without compromising uterine blood flow in our version of laparoscopic sacrohysteropexy.
laparoscopy; uterine preservation; sacrohysteropexy; uterovaginal prolapse
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