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Re: Sacrospinous FixationFrom: Bernard Cristalli (bclaure@http://www.club-internet.fr)Sat Jan 25 12:03:42 1997
Michael J. Wolpmann, M.D. wrote: > > 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? > Everything depends on the age of the pt. I've been bred in the abdominal Sub-total hysterectomy + sacropexy + Burch &turned to the vaginal route. I'm rather a vaginalist now. For a young patient the abdominal way seems to be the best. For an old woman TVH + Richter, or if she is really old with no more sexual activity Lefort or Rouhier procedure (total colpectomy + partitioning). For the laparoscopic I think it's much ado about nothing. It can be useful for a young woman who wants to keep her uterus & have children…
-- Bernard Cristalli MD CNGOF Paris - France
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