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International Urogynecology Journal

, Volume 25, Issue 12, pp 1729–1730 | Cite as

Overlapping sphincteroplasty and posterior repair

  • Andrea K. CraneEmail author
  • Erinn M. Myers
  • Quinn K. Lippmann
  • Catherine A. Matthews
IUJ Video

Abstract

Introduction and hypothesis

Knowledge of how to anatomically reconstruct extensive posterior-compartment defects is variable among gynecologists. The objective of this video is to demonstrate an effective technique of overlapping sphincteroplasty and posterior repair.

Methods

In this video, a scripted storyboard was constructed that outlines the key surgical steps of a comprehensive posterior compartment repair: (1) surgical incision that permits access to posterior compartment and perineal body, (2) dissection of the rectovaginal space up to the level of the cervix, (3) plication of the rectovaginal muscularis, (4) repair of internal and external anal sphincters, and (5) reconstruction of the perineal body. Using a combination of graphic illustrations and live video footage, tips on repair are highlighted.

Results

The goals at the end of repair are to: (1) have improved vaginal caliber, (2) increase rectal tone along the entire posterior vaginal wall, (3) have the posterior vaginal wall at a perpendicular plane to the perineal body, (4) reform the hymenal ring, and (5) not have an overly elongated perineal body.

Conclusion

This video provides a step-by-step guide on how to perform an overlapping sphincteroplasty and posterior repair.

Keywords

Fecal incontinence Overlapping sphincteroplasty Posterior repair 

Notes

Conflicts of interest

Andrea Crane, MD received an honorarium from Allied Minds for consultation on an educational tool. Catherine Matthews, MD received a robotics fellowship grant from Intuitive Surgical.

Supplementary material

ESM 1

(M4V 86015 kb)

References

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Copyright information

© The International Urogynecological Association 2014

Authors and Affiliations

  • Andrea K. Crane
    • 1
    Email author
  • Erinn M. Myers
    • 1
  • Quinn K. Lippmann
    • 1
  • Catherine A. Matthews
    • 1
  1. 1.Department of Obstetrics and Gynecology, Division of Urogynecology and Reconstructive Pelvic SurgeryUniversity of North Carolina at Chapel HillChapel HillUSA

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