PROLAPS UTERIN TOTAL - IMPLANT ANTERIOR sI POSTERIOR ĪN MANIERA "TENSION-FREE"
Introduction and objectives
Total prolaps is a rare condition when the indication and technique for hysterectomy is appl 525d34f ied.
Material and method
In this video, the author presents his surgical experience with six patients with total prolapse.
For classification we used Baden Walker and POPQ quantitative system.
The overall age of the patients was 64 years.
We use implants consisting in self made polypropylene mesh initially used to cure hernia. Also, the needles are not the original ones.
The procedure starts by a median incision from the bladder neck stopped 2 cm from the hysterectomy vagina scar, then hidro-disection which allows a correct dissection. After isolating the bladder, the mesh is positioned under the bladder and anchored to the utherine cervix. The four arms of the graft is pulled out of the obturator foramen in a safety zone.
The mesh should be underneath the cystocel in a tension-free manner.
For infra-coccigial sacropexy a specially constructed mesh that has two anchoring tails is necessary. It is use for the creation of neo-sacrouterin ligaments. After the posterior wall incision, the index is introduced in the ischio-rectal space, just in front of ischial spine. The central mesh is fixed to the posteropr [art of the cervix.
Results and conclusions
We/ve noticed no complication. In spite of the short time, the preliminary results are promising, and the cosmetic aspect is very good.
Those interventions with special implant materials are very good means to treat total prolaps.
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