ILIOCOCCYGEUS FASCIA VERSUS SACROSPINOUS LIGAMENT COLPOPEXY IN THE PREVENTION AND TREATMENT OF VAULT PROLAPSE

Abstract

Patients with pelvic support defects reqmre meticulous preoperative and intraoperative identification of all areas requiring repair.

Because of its strategic anatomic location between the anterior and posterior segments, superior segmental prolapse of the uterus or vaginal cuff often causes traction descent of the anterior or posterior vaginal wall. Because of this, the first step in any anterior or posterior vaginal repair is to ensure optimal (grade 0) support at the superior segmental uterine and cul-de-sac sites.

Both abdominal and vaginal techniques have been reported to successfully correct vaginal vault prolapse. The vaginal approach is most appropriate because it allows concomitant repair of all vaginal defects.

In cases of moderate or severe uterovaginal prolapse, adjunct vaginal apex support may be necessary and these patients may be candidates for more than just uterosacral/cardinal ligament complex attachment to the vaginal vault.