, Volume 17, Issue 2, pp 231-233
Date: 16 Nov 2012

Dynamic forceps-assisted vaginal anoscopy for entero-recto-cystocele

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The vaginal insertion of an anoscope with an oblique end (Sapimed, Alessandria, Italy), in patients with urogynecological and intestinal dysfunction is routinely used at our Unit (Fig. 1). By gently retracting the posterior and/or anterior vaginal wall using forceps, it is possible to prevent the descent of rectocele and cystocele, respectively (Figs. 2, 3). Moreover, rotation and correct orientation of the proctoscope help identifying each lesion (Fig. 4).Fig. 1

Female patient in the Sims’ position, and the proctoscope with the oblique distal opening
Fig. 2
How to use the proctoscope and the Emmet forceps during vaginal inspection. From left to right (Sagittal view). The movements of both the oblique tip of the proctoscope and the forceps allow a clear endoscopic view of the “celes” on straining. Rectocele: brown. Enterocele: black. Prolapsed uterus: pinkblack. Cystocele: violet. Urethrocele: red
Fig. 3
Forceps-assisted dynamic vaginoscopy in a patient with urinary incontinence, obstructe