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Vault Proplapse Repair

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North Cumbria University Hospitals NHS Trust
North Cumbria University Hospitals NHS Trust

A powerpoint presentation on management of vault prolapse.It is based on RCOG guidelines.

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Management of Vault prolapse Based on RCOG guide lines Dr.V.Ravimohan www.mrcogexam.net
Definition ,[object Object],[object Object],[object Object]
Prevention ,[object Object],[object Object],[object Object],[object Object],[object Object]
Prevention ,[object Object],[object Object]
Assessment ,[object Object],[object Object],[object Object],[object Object]
 
What is POPQ? ,[object Object],[object Object]
POPQ ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Point A ,[object Object]
Point B ,[object Object]
Point C &D ,[object Object],[object Object],[object Object]
occult stress incontinence ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Indirect recurrence ,[object Object],[object Object],[object Object]
 
Conservative management ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Surgical procedures ,[object Object],[object Object],[object Object]
Surgical procedures ,[object Object],[object Object]
Sacrospinous fixation ,[object Object]
Sacrocolpopexy ,[object Object]
more sexual dysfunction more intraoperative blood loss longer catheter use, more urinary tract infection and more urinary incontinence . a lower rate of recurrence combined rate of apical and anterior vaginal wall prolapse was significantly higher posterior vaginal wall prolapse following abdominal sacrocolpopexy. higher cost slower return to normal activity operating time and hospital stay were shorter significantly longer operating time Sacrospinous fixation Sacroxcolpopexy
Cochrane review Sacrospinous fixation Sacroxcolpopexy cheaper Quicker return to normal activities a lower rate of recurrence Shorter operation time less dyspareunia
continence surgery be performed at the time of sacrocolpopexy? ,[object Object],[object Object]
unilateral or bilateral sacrospinous fixation? ,[object Object]
iliococcygeus fixation ,[object Object]
iliococcygeus fixation…. ,[object Object],[object Object],[object Object],[object Object]
vaginal uterosacral ligament suspension ,[object Object],[object Object],[object Object]
laparoscopic procedures ,[object Object],[object Object],[object Object]
Sacrocolpopexy-Open Vs Laparoscopy requires skill, training and longer operating time, although operating time shortens with greater experience. shorter stay reduced postoperative morbidity less scarring an enhanced view of the pelvis, which facilitates a more anatomical repair laparoscopy open
Colpocleisis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Sling procedures ,[object Object],[object Object],[object Object]
total mesh reconstruction ,[object Object]
Vault suspension to the anterior abdominal wall ,[object Object]
[object Object]

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Vault Proplapse Repair

  • 1. Management of Vault prolapse Based on RCOG guide lines Dr.V.Ravimohan www.mrcogexam.net
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  • 20. more sexual dysfunction more intraoperative blood loss longer catheter use, more urinary tract infection and more urinary incontinence . a lower rate of recurrence combined rate of apical and anterior vaginal wall prolapse was significantly higher posterior vaginal wall prolapse following abdominal sacrocolpopexy. higher cost slower return to normal activity operating time and hospital stay were shorter significantly longer operating time Sacrospinous fixation Sacroxcolpopexy
  • 21. Cochrane review Sacrospinous fixation Sacroxcolpopexy cheaper Quicker return to normal activities a lower rate of recurrence Shorter operation time less dyspareunia
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  • 28. Sacrocolpopexy-Open Vs Laparoscopy requires skill, training and longer operating time, although operating time shortens with greater experience. shorter stay reduced postoperative morbidity less scarring an enhanced view of the pelvis, which facilitates a more anatomical repair laparoscopy open
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