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[Clinical application of a modified posterior vaginal wall hammock in female pelvic floor reconstruction]
Jia-jing Cheng1, Yi Zhang, Yi Wu
1Department of Obstetrics and Gynecology, Tenth People's Hospital of Shanghai, Shanghai Tongji University, China.
Objective:
To explore the feasibility and effectiveness of a modified posterior vaginal wall hammock (PVWH) in the treatment of female pelvic organ prolapse without removal of uterus.
Methods:
Thirty-two patients with different defects of pelvic organ prolapse underwent a modified PVWH. The procedures included restoring the position of prolapsed uterus by suturing polypropylene mesh to bilateral sacro-spinous ligaments, strengthening utero-sacral ligament by intra-vaginal slingplasty (Tyco Healthcare Group), forming a new recto-vaginal fascia and strengthening levator ani muscle.
Results:
The average operating time was 55 minutes and hemorrhage was 150 ml respectively. Recovery of uterine prolapse was achieved in all cases. After an average follow up of seven months, no vagina distortion, shortening and dyspareunia were observed. One patient had uterine cervix elongation three months after operation. The relieving rate of subjective symptoms was more than 50%.
Conclusions:
Female uterine prolapse could be cured by the modified PVWH and the uterus could be successfully reserved during pelvic floor reconstruction with promising short-term results. More clinical trials are needed to evaluate its effectiveness, safety and long-term outcome.
