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Sacrospinous FixationFrom: Michael J. Wolpmann, M.D. (elvis@llano.net)Sat Jan 25 04:55:22 1997
Interested in how members of the list are treating complete procidentia with vault eversion? TVH with sacrospinous fixation? TVH with McCall culdeplasty? TAH with abdominal colposacropexy? LAVH with laparoscopic colposacropexy? As I prefer to operate vaginally if at all possible, abdominal route seems less attractive. But seem to have read recent study showing abdominal colposacropexy more durable procedure. And many state procidentia with complete vault eversion should only be managed abdominally to affect more anatomic repair (no angulation of vault). What do the members do and why? Although McCall great to prevent enterocele, will it also help keep the vault suspended if combined with fixating uterosacral ligaments to vault apex? A vaginal surgeon I greatly respect uses this exclusively with excellent results. But if postmenopausal pt has no uterosacral ligaments left, is SS fixation best option vaginally and do you consider it superior to abdominal approach? Is there a laparoscopic option with proven benefit? Is anyone on the list doing laparoscopic colposacropexy and what are your short and long term results? Sorry to post such a long message. Thank you for any input. Michael
-- Michael J. Wolpmann, M.D.
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