Correction of uterine prolapse by the vaginal route using the uterosacral ligaments: Shirodkar procedure

2003 ◽  
Vol 109 (2) ◽  
pp. 214-218 ◽  
Author(s):  
Gil Dubernard ◽  
Roman Rouzier ◽  
Bassam Haddad ◽  
Philippe Dubois ◽  
Bernard-Jean Paniel
Keyword(s):  
Uterine Prolapse ◽  
Vaginal Route ◽  
Uterosacral Ligaments

Cure of Interstitial Cystitis and Non-Ulcerating Hunner’s Ulcer by Cardinal/Uterosacral Ligament Repair

2021 ◽  
pp. 1-4
Author(s):  
Kay Scheffler ◽  
Oliver W. Hakenberg ◽  
Peter Petros
Keyword(s):  
Interstitial Cystitis ◽  
Uterine Prolapse ◽  
English Literature ◽  
German Literature ◽  
Uterosacral Ligament ◽  
Original Intention ◽  
Uterosacral Ligaments ◽  
Bladder Symptoms ◽  
Posterior Fornix ◽  
The Relationship

A serendipitous cure in a 73-year-old woman of Hunner’s ulcer, urge, nocturia, apical prolapse by a tissue fixation system tensioned minisling (TFS) which reinforced the cardinal, and uterosacral ligaments (USLs) led us to analyse the relationship between Hunner’s ulcer and known pain conditions associated with USL laxity. The original intention was to cure the “posterior fornix syndrome” (PFS), uterine prolapse, and associated pain and bladder symptoms by USL repair. A speculum inserted preoperatively into the posterior fornix alleviated pain and urge symptoms, by mechanically supporting USLs. Hunner’s ulcer, along with pain and other PFS symptoms were cured by USL repair. The concept of USL laxity causing chronic pelvic pain and bladder problems is not new. It was published in the German literature by Heinrich Martius in 1938 and by Petros in the English literature in 1993. These findings raise important questions. As PFS symptoms are identical with those of interstitial cystitis (IC), are PFS and IC similar conditions? If so, then patients with IC who have a positive speculum test are at least theoretically, potentially curable by USL repair. These questions need to be explored.

scholarly journals Gynecologists’ perspectives on two types of uterus-preserving surgical repair of uterine descent; sacrospinous hysteropexy versus modified Manchester

2020 ◽  
Author(s):  
Rosa A. Enklaar ◽  
Brigitte A. B. Essers ◽  
Leanne ter Horst ◽  
Kirsten B. Kluivers ◽  
Mirjam Weemhoff
Keyword(s):  
Decision Making ◽  
Uterine Prolapse ◽  
Final Decision ◽  
Evidence Based ◽  
Patient Counseling ◽  
Structured Interviews ◽  
Sacrospinous Hysteropexy ◽  
Uterosacral Ligaments ◽  
Choice Of Procedure ◽  
Uterine Descent

Abstract Introduction and hypothesis The modified Manchester (MM) and sacrospinous hysteropexy (SSH) are the most common uterus-preserving surgical procedures for uterine descent. Little is known about gynecologists’ preferences regarding the two interventions. The study’s aim was to identify which factors influence Dutch (uro)gynecologists when choosing one of these techniques. Methods This qualitative study consists of ten semi-structured interviews with Dutch (uro)gynecologists using predetermined, open explorative questions, based on a structured topic list. An inductive content analysis was performed using Atlas.ti. Results For SSH, the majority (6/10 gynecologists) reported the more dorsal change of direction of the vaginal axis as a disadvantage and expected more cystocele recurrences (7/10). The most reported disadvantage of MM was the risk of cervical stenosis (7/10). Four gynecologists found MM not to be appropriate for patients with higher stage uterine prolapse. The quality of the uterosacral ligaments was related to the chance of recurrence according to five gynecologists. Patient counseling was biased toward one of the uterus-preserving operations (7/10). Four gynecologists stated they make the final decision while two let patient-preference lead the final decision. Conclusions Preference for one of the uterus-preserving interventions is mainly based on the gynecologist’s own experience and background. The lack of information regarding these two uterus-preserving procedures hampers evidence-based decision making, which explains the practice pattern variation. In conclusion, further research is needed to improve evidence-based counseling and shared decision making regarding the choice of procedure.

scholarly journals Clinicopathological study of hysterectomised specimens

2016 ◽  
Vol 6 (1) ◽  
pp. 246
Author(s):  
Saravana A. ◽  
Shashikala B. Patil ◽  
Savitha S. Patil
Keyword(s):  
Clinical Diagnosis ◽  
Uterine Prolapse ◽  
Treatment Options ◽  
Histopathological Finding ◽  
Histopathological Analysis ◽  
Histopathological Diagnosis ◽  
Vaginal Route ◽  
Effective Treatment Option ◽  
Fibroid Uterus ◽  
Common Diagnosis

Background: Hysterectomy is the commonest major surgical procedure performed in gynecology. It can be done by abdominal or vaginal route and with the help of laparoscopy. Hysterectomy is an effective treatment option for many conditions like fibroid, abnormal uterine bleeding, endometriosis, adenomyosis, uterine prolapse, pelvic inflammatory disease and cancer of reproductive organ when other treatment options are contraindicated or have failed, or if the woman no longer wishes to retain her menstrual and reproductive. The aim and objective of the study was to correlate indications of hysterectomy with histopathological findings in hysterectomised patients.Methods: A retrospective study was carried on 113 hysterectomised cases over a period of one year from June 2015 to May 2016. The data regarding the patient’s age, parity, clinical diagnosis, type of hysterectomy and histopathological diagnosis were reviewed by the records and analyzed.Results: A total of 113 cases of hysterectomies were studied. Hysterectomies were distributed over a wide age ranging from 20 years to 75 years. Most common age group was 41-50 years. Among hystectomies majority were done through vaginal route 86 (76.1%) and 26 (23%) cases were done through abdominal route. Most common clinical diagnosis was fibroid uterus in 44(38.9%) cases. Most of the hysterectomies were done for benign conditions. In final histopathological report most common diagnosis was fibroid uterus in 45(39.8%) hysterectomy specimens. It was correlated well with clinical diagnosis. Next most common histopathological diagnosis was Adenomyosis.Conclusions: Histopathological analysis correlated well with preoperative clinical diagnosis in majority of cases. The commonest indication and histopathological finding in our study was fibroid uterus. Next most common histopathological finding was Adenomyosis. Most commonly hysterectomies were done through vaginal route in our study.

Laparoscopic uterosacral ligaments plication for the treatment of uterine prolapse

2006 ◽  
Vol 276 (3) ◽  
pp. 225-229 ◽  
Author(s):  
Stefano Uccella ◽  
Fabio Ghezzi ◽  
Valentino Bergamini ◽  
Maurizio Serati ◽  
Antonella Cromi ◽  
...  
Keyword(s):  
Uterine Prolapse ◽  
Uterosacral Ligaments
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