Vaginal Vault Suspension at Hysterectomy for Prolapse – Myths and Facts, Anatomical Requirements, Fixation Techniques, Documentation and Cost Accounting

F. Graefe; J. Marschke; T. Dimpfl; R. Tunn

doi:10.1055/s-0032-1328061

GebFra - DGGG-Gesellschaftsausgaben, Table of Contents

Geburtshilfe Frauenheilkd 2012; 72(12): 1099-1106
DOI: 10.1055/s-0032-1328061

Review

Georg Thieme Verlag KG Stuttgart · New York

Vaginal Vault Suspension at Hysterectomy for Prolapse – Myths and Facts, Anatomical Requirements, Fixation Techniques, Documentation and Cost Accounting

Scheidenstumpffixation im Rahmen der Prolaps-Hysterektomie – Mythen und Fakten, anatomische Voraussetzungen, Fixationstechniken, Dokumentation und Abrechnung

F. Graefe

¹Urogynäkologie, Deutsches Beckenbodenzentrum, Berlin

,

J. Marschke

¹Urogynäkologie, Deutsches Beckenbodenzentrum, Berlin

,

T. Dimpfl

²Frauenheilkunde und Geburtshilfe, Klinikum Kassel, Kassel

,

R. Tunn

¹Urogynäkologie, Deutsches Beckenbodenzentrum, Berlin

› Author Affiliations

Abstract

Vaginal vault suspension during hysterectomy for prolapse is both a therapy for apical insufficiency and helps prevent recurrence. Numerous techniques exist, with different anatomical results and differing complications. The description of the different approaches together with a description of the vaginal vault suspension technique used at the Department for Urogynaecology at St. Hedwig Hospital could serve as a basis for reassessment and for recommendations by scientific associations regarding general standards.

Zusammenfassung

Die Scheidenstumpffixation im Rahmen der Prolaps-Hysterektomie ist Therapie der apikalen Insuffizienz und gleichermaßen Rezidivprophylaxe. Es existieren zahlreiche Techniken, die mit unterschiedlichen anatomischen Resultaten und Komplikationen einhergehen. Die Darstellung der verschiedenen Vorgehensweisen und Vorstellung der Scheidenstumpffixationstechnik der Klinik für Urogynäkologie am St. Hedwig Krankenhaus kann als Grundlage für eine Neubewertung und Empfehlung durch die Fachgesellschaften zu einem einheitlichen Standard dienen.

Key words

Vaginal vault suspension - hysterectomy - prolapse - standard

Schlüsselwörter

Scheidenstumpffixation - Hysterektomie - Prolaps - Standard

Full Text

References

References
1 Corman M. Classic articles in colonic and rectal surgery. Alexis Victor Moschcowitz, 1865–1937. The pathogenesis, anatomy, and cure of prolapse of the rectum. Dis Colon Rectum 1983; 26: 553-565
2 Moschcowitz AV. The pathogenesis, anatomy, and cure of prolapse of the rectum. Surg Gynecol Obstet 1912; 15: 7-12
3 Halban J. Gynäkologische Operationslehre. 1.. Aufl. Berlin, Wien: Urban & Schwarzenberg; 1932: 170-173
4 McCall ML. Posterior culdeplasty. Obstet Gynecol 1957; 10: 595-602
5 Aronson MP, Aronson PK, Howard AE et al. Low risk of ureteral obstruction with “deep” (dorsal/posterior) uterosacral ligament suture placement for transvaginal apical suspension. Am J Obstet Gynecol 2005; 192: 1530-1536
6 Cruikshank SH, Kovac SR. Randomized comparison of three surgical methods used at the time of vaginal hysterectomy to prevent posterior enterocele. Am J Obstet Gynecol 1999; 180: 859-865
7 Neeser E, Keller E, Hirsch HA. Prophylaxe des Scheidenvorfalls bei der Hysterektomie durch Suspension des Vaginalstumpfes. Geburtsh Frauenheilk 1990; 50: 789-793
8 Colombo M, Milani R. Sacrospinous ligament fixation and modified McCall culdoplasty during vaginal hysterectomy for advanced uterovaginal prolapse. Am J Obstet Gynecol 1998; 179: 13-20
9 Chene G, Tardieu AS, Savary D et al. Anatomical and functional results of McCall culdoplasty in the prevention of enteroceles and vaginal vault prolapse after vaginal hysterectomy. Int Urogynecol J 2008; 19: 1007-1011
10 Montella JM, Morrill MY. Effectiveness of the McCall culdeplasty in maintaining support after vaginal hysterectomy. Int Urogynecol J 2005; 16: 226-229
11 Shull BL, Bachofen C, Coates KW et al. A transvaginal approach to repair of apical and other associated sites of pelvic organ prolapse with uterosacral ligaments. Am J Obstet Gynecol 2000; 183: 1365-1374
12 Richter K. Die chirurgische Anatomie der Vaginaefixatio sacrospinalis vaginalis. Ein Beitrag zur operativen Behandlung des Scheidenblindsackprolapses. Geburtsh Frauenheilk 1968; 28: 321-327
13 Maher CF, Cary MP, Slack MC et al. Uterine preservation or hysterectomy at sacrospinous colpopexy for uterovaginal prolapse?. Int Urogynecol J 2001; 12: 381-385
14 Lopes ED, Lemos NL, Carramão Sda S et al. Transvaginal polypropylene mesh versus sacrospinous ligament fixation for the treatment of uterine prolapse: 1-year follow-up of a randomized controlled trial. Int Urogynecol J 2010; 21: 389-394
15 Bensinger G, Lind L, Lesser M et al. Abdominal sacral suspensions: analysis of complications using permanent mesh. Am J Obstet Gynecol 2005; 193: 2094-2098
16 Tunn R, DeLancey JO, Quint EE. Visibility of pelvic organ support system structures in magnetic resonance images without an endovaginal coil. Am J Obstet Gynecol 2001; 184: 1156-1163
17 DeLancey JO. Anatomic aspects of vaginal eversion after hysterectomy. Am J Obstet Gynecol 1992; 166: 1717-1724
18 Jacquetin B, Fatton B, Rosenthal C et al. Total transvaginal mesh (TVM) technique for treatment of pelvic organ prolapse: a 3-year prospective follow-up study. Int Urogynecol J 2010; 21: 1455-1462