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GYN: Vault prolapseFrom: Garry E. Siegel, M.D. (garrys@mindspring.com)Fri Feb 26 21:17:26 1999
Suggestions, please: 56 YO P2002 who is 18 mos out from a TVH, A/P repair, McCalls for cystocele/rectocele, done by yours truly, now has a vault prolapse where the apex of the cuff is prolapsed beyond the introitus, but reduces. She really doesn't have much of a cystocele/rectocele, and at the time of her sugery, her small enterocele was handled (well, now subject to debate)by internal and external culdoplasty stitches. She has been on estrogen, and has no urinary incontinence. She is a nonsmoker, thin and gives you the impression that she doesn't have the sturdiest of tissue (I'm not sure why I feel that way, but I do). I am most comfortable with a sacrospinous ligament repair, but kind of lean towards an abdominal sacrocolpopexy with mesh. I would tend not to do a urinary anti-incontinence procedure, either. Lastly, there is a doc in my area who does the big cases like this through the scope, and has done some kind of extra training, etc. Any thoughts? Garry
-- Garry E. Siegel, M.D., FACOG Private Practice Roswell, Ga.
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