Uterosacral Ligament Vaginal Vault Suspension

Chapter

Abstract

Uterosacral ligament vaginal vault suspension is an elegant reconstructive procedure for apical prolapse which restores the natural vaginal axis using solely native tissue supports. It is suited to women with moderate apical prolapse in which the uterosacral ligaments are likely to be preserved. It can be employed in combination with hysterectomy or in the case of moderate post-hysterectomy vault prolapse. Important points are highlighted, including avoidance of nerve and ureteric injury (see also Chapter 1). Uterosacral ligament suspension can be performed concurrent with other repairs and is one of several options for addressing apical prolapse. In the event that the uterosacral ligaments are unsatisfactory, the surgeon should be prepared to offer alternative repairs to address apical prolapse (see also Chapters 8, 10, 11 and 14).

Keywords

Cystocele Hysterectomy Uterosacral ligaments Pelvic organ prolapse Rectocele Sutures Uterine prolapse Vagina 

Abbreviations

FIGO

International Federation of Gynecology and Obstetrics

Pdet

Detrusor pressure

POP-Q

Pelvic Organ Prolapse Quantification

Qmax

Maximum urinary flow rate

SSL

Sacrospinous Ligament

USL

Uterosacral Ligament

Supplementary material

Video 9.1

(MP4 0 kb)

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Copyright information

© Springer International Publishing Switzerland 2017

Authors and Affiliations

  1. 1.Stanford University School of Medicine, Department of UrologyStanfordUSA
  2. 2.Division of UrologyMC 208, Albany Medical CenterAlbanyUSA

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