Efficacy of a standardized technique of trans-vaginal entry into the peritoneal cavity for post-hysterectomy vaginal vault suspension.

Published

Journal Article

The aim of this paper is to describe the efficacy and safety of a standardized technique of trans-vaginal entry into the peritoneal cavity for post-hysterectomy vault prolapse and determine how well the pre-operative pelvic examination predicted successful peritoneal entry. A retrospective review of patients undergoing post-hysterectomy trans-vaginal apical suspensions using a standardized technique of peritoneal entry was employed in this study. A subset of patients underwent a standardized pre-operative evaluation to predict what organ was behind the vaginal cuff and posterior cul-de-sac. Peritoneal entry was attempted in 280 patients, and successfully achieved in 223(80%). One cystotomy and one proctotomy (0.3%) occurred during attempted entry. Of those who underwent the standardized pre-operative evaluation, peritoneal entry was successful 86% of the time when small bowel was predicted to lie behind the vaginal cuff or posterior cul-de-sac. Peritoneal entry can be safely achieved in the majority of post-hysterectomy prolapse patients. Pre-operative examination assists in predicting successful peritoneal entry.

Full Text

Cited Authors

  • Park, AJ; Ridgeway, B; Gustilo-Ashby, AM; Paraiso, MFR; Walters, MD; Barber, MD

Published Date

  • October 2008

Published In

  • Int Urogynecol J Pelvic Floor Dysfunct

Volume / Issue

  • 19 / 10

Start / End Page

  • 1393 - 1398

PubMed ID

  • 18478174

Pubmed Central ID

  • 18478174

Digital Object Identifier (DOI)

  • 10.1007/s00192-008-0642-7

Language

  • eng

Conference Location

  • England