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Bilateral uterosacral ligament vaginal vault suspension with site-specific endopelvic fascia defect repair for treatment of pelvic organ prolapse.

Publication ,  Journal Article
Barber, MD; Visco, AG; Weidner, AC; Amundsen, CL; Bump, RC
Published in: Am J Obstet Gynecol
December 2000

OBJECTIVE: The anatomic and functional success of suspension of the vaginal cuff to the proximal uterosacral ligaments is described. STUDY DESIGN: Forty-six women underwent vaginal site-specific repair of endopelvic fascia defects with suspension of the vaginal cuff to the proximal uterosacral ligaments for pelvic organ prolapse. Outcome measures included operative complications, pelvic organ prolapse quantitation, and assessment of pelvic floor symptoms. RESULTS: After a median follow-up of 15.5 months (range, 3.5 months-3.4 years), 90% of patients had both resolution of vaginal bulging or prolapse symptoms and improvement of the stage of prolapse. There were improvements in all pelvic organ prolapse quantitation measurements except for total vaginal length, for which the median decrease was 0.75 cm. Intraoperatively, ureteral occlusion was noted in 11% (5/46) of patients with universal cystoscopy. In 3 patients the uterosacral suspension sutures were removed and replaced with resolution of the occlusion and in 2 patients ureteral reimplantation was required. Symptomatic prolapse (2 apical segment, 1 anterior, and 1 posterior) developed in 4 patients (10%), and 3 of them underwent reoperation. There were significant improvements in symptoms of bulging and pressure, voiding dysfunction, and vaginal and perineal splinting. CONCLUSION: Suspension of the vaginal vault to the proximal uterosacral ligaments combined with site-specific repair of endopelvic fascia defects provides excellent anatomic and functional correction of pelvic organ prolapse in most women. The risk of ureteral injury with this technique makes intraoperative cystoscopy essential.

Duke Scholars

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Published In

Am J Obstet Gynecol

DOI

ISSN

0002-9378

Publication Date

December 2000

Volume

183

Issue

6

Start / End Page

1402 / 1410

Location

United States

Related Subject Headings

  • Vagina
  • Uterus
  • Uterine Prolapse
  • Treatment Outcome
  • Sacrococcygeal Region
  • Reoperation
  • Postoperative Complications
  • Obstetrics & Reproductive Medicine
  • Middle Aged
  • Ligaments
 

Citation

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Barber, M. D., Visco, A. G., Weidner, A. C., Amundsen, C. L., & Bump, R. C. (2000). Bilateral uterosacral ligament vaginal vault suspension with site-specific endopelvic fascia defect repair for treatment of pelvic organ prolapse. Am J Obstet Gynecol, 183(6), 1402–1410. https://doi.org/10.1067/mob.2000.111298
Barber, M. D., A. G. Visco, A. C. Weidner, C. L. Amundsen, and R. C. Bump. “Bilateral uterosacral ligament vaginal vault suspension with site-specific endopelvic fascia defect repair for treatment of pelvic organ prolapse.Am J Obstet Gynecol 183, no. 6 (December 2000): 1402–10. https://doi.org/10.1067/mob.2000.111298.
Barber MD, Visco AG, Weidner AC, Amundsen CL, Bump RC. Bilateral uterosacral ligament vaginal vault suspension with site-specific endopelvic fascia defect repair for treatment of pelvic organ prolapse. Am J Obstet Gynecol. 2000 Dec;183(6):1402–10.
Barber, M. D., et al. “Bilateral uterosacral ligament vaginal vault suspension with site-specific endopelvic fascia defect repair for treatment of pelvic organ prolapse.Am J Obstet Gynecol, vol. 183, no. 6, Dec. 2000, pp. 1402–10. Pubmed, doi:10.1067/mob.2000.111298.
Barber MD, Visco AG, Weidner AC, Amundsen CL, Bump RC. Bilateral uterosacral ligament vaginal vault suspension with site-specific endopelvic fascia defect repair for treatment of pelvic organ prolapse. Am J Obstet Gynecol. 2000 Dec;183(6):1402–1410.
Journal cover image

Published In

Am J Obstet Gynecol

DOI

ISSN

0002-9378

Publication Date

December 2000

Volume

183

Issue

6

Start / End Page

1402 / 1410

Location

United States

Related Subject Headings

  • Vagina
  • Uterus
  • Uterine Prolapse
  • Treatment Outcome
  • Sacrococcygeal Region
  • Reoperation
  • Postoperative Complications
  • Obstetrics & Reproductive Medicine
  • Middle Aged
  • Ligaments