Proteomics of Uterosacral Ligament Connective Tissue from Women with and without Pelvic Organ Prolapse

2018 ◽  
Vol 13 (4) ◽  
pp. 1800086
Author(s):  
Xiang‐Juan Li ◽  
Hai‐Tao Pan ◽  
Juan‐Juan Chen ◽  
Yi‐Bin Fu ◽  
Min Fang ◽  
...  
Keyword(s):  
Pelvic Organ Prolapse ◽  
Connective Tissue ◽  
Pelvic Organ ◽  
Uterosacral Ligament

scholarly journals To Compare the Effectiveness of Vaginal High Uterosacral Ligament Suspension and McCall's Culdoplasty during Vaginal Hysterectomy for Pelvic Organ Prolapse

2017 ◽  
Vol 5 (2) ◽  
pp. 81-86
Author(s):  
Krutika Bhalerao ◽  
Anuja V Bhalerao ◽  
Richa Garg
Keyword(s):  
Pelvic Organ Prolapse ◽  
Coming Out ◽  
Vaginal Hysterectomy ◽  
Pelvic Organ ◽  
Uterosacral Ligament ◽  
Vaginal Vault ◽  
Care Hospital ◽  
Uterosacral Ligament Suspension ◽  
Vaginal Length ◽  
Vault Suspension

ABSTRACT Introduction Vaginal vault prolapse can be prevented by supporting the vaginal cuff, which is an essential part of hysterectomy, whether done abdominally or vaginally. The American Association of Gynecologic Laparoscopists (AAGL) has recommended for future research, specifically, a randomized trial comparing McCall's culdoplasty (with uterosacral ligament plication) with vaginal high uterosacral ligament suspension (HUSLS) (without plication), since both procedures are accessible to gynecological surgeons without urologic background. Hence, this study was carried out. Aim To compare both anatomic and functional outcomes of patients undergoing vaginal HUSLS or McCall's culdoplasty at the time of vaginal hysterectomy. Materials and methods This hospital-based prospective comparative study was carried out at a tertiary care hospital from January 1, 2013 to December 31, 2015 over a period of 3 years after obtaining Ethical Committee approval. All women attending gynecological outpatient department having symptom of mass coming out of vagina were subjected to detailed history, examination, and later underwent either HUSLS (43) or McCall's culdoplasty (42), for vault suspension with concomitant hysterectomy. The effectiveness of both the procedures was assessed by preoperative and postoperative pelvic organ prolapse quantification (POP-Q) and both were compared. Observations There was statistically significant improvement in all the sites of POP-Q points by HUSLS and McCall's culdoplasty as a method of vault suspension except in total vaginal length (TVL). Vault suspension by HUSLS is better than McCall's culdoplasty. All the points of POP-Q showed better results but the point C was significantly placed at a higher level by HUSLS (p = 0.000) as compared with McCall's culdoplasty. The time required for HUSLS was statistically more as compared with repair by McCall's culdoplasty (81.55/74.53 minutes, T: 1.981, p: 0.05). Complications, such as hemorrhage and ureteric injuries were more in HUSLS (2/43, 4.8%) as compared with McCall's culdoplasty (0/42); this is statistically significant. Conclusion High uterosacral ligament suspension provides excellent suspensory support to vaginal vault. Vagina is suspended over the levator ani with normal axis toward sacrum. By doing HUSLS, the vagina is symmetrically supported directed toward the hollow of sacrum. High uterosacral ligament suspension is highly recommended for young women with POP as vaginal length is not altered at all and so is the quality of life. How to cite this article Bhalerao AV, Bhalerao K, Garg R. To Compare the Effectiveness of Vaginal High Uterosacral Ligament Suspension and McCall's Culdoplasty during Vaginal Hysterectomy for Pelvic Organ Prolapse. J South Asian Feder Menopause Soc 2017;5(2):81-86.

scholarly journals Proteomic Analysis of the Uterosacral Ligament in Postmenopausal Women with and without Pelvic Organ Prolapse

2015 ◽  
Vol 128 (23) ◽  
pp. 3191-3196 ◽  
Author(s):  
Zhi-Jing Sun ◽  
Lan Zhu ◽  
Jing-He Lang ◽  
Zhao Wang ◽  
Shuo Liang
Keyword(s):  
Pelvic Organ Prolapse ◽  
Postmenopausal Women ◽  
Proteomic Analysis ◽  
Pelvic Organ ◽  
Uterosacral Ligament

scholarly journals “Locus minoris resistentiae” and connective tissue weakness in older women: a case report and literature review on pelvic organ prolapse with inguinal bladder hernia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
A. Esber ◽  
A. Kopera ◽  
M. P. Radosa ◽  
I. B. Runnebaum ◽  
H. K. Mothes ◽  
...  
Keyword(s):  
Case Report ◽  
Inguinal Hernia ◽  
Pelvic Organ Prolapse ◽  
Connective Tissue ◽  
Genital Prolapse ◽  
Pelvic Organ ◽  
Simultaneous Occurrence ◽  
Patient Counselling ◽  
Hernia Sac ◽  
Bladder Hernia

Abstract Background Conditions such as genital prolapse and hernia are known to be related to connective tissue dysfunction. In this report on cases of the rare simultaneous finding of large genital prolapse and post-prolapse repair female inguinal bladder hernia, we aim to contribute to the discussion of a possible clinical definition of connective tissue weakness, for its clinical assessment and preoperative patient counselling. Case presentation Three cases of medial third-grade (MIII, Aachen classification) inguinal bladder hernia developing or enlarging after successful stage-IV pelvic organ prolapse (POP) repair at a university pelvic floor centre are presented. All patients were aged ≥ 80 years with long-standing postmenopausal status. One patient was followed for 5 years and two patients were followed for 6 months. In all patients, ultrasound revealed that the hernia sac contained the urinary bladder, which had herniated through the inguinal hernia orifice. A literature search revealed only one case report of direct female inguinal bladder hernia and few investigations of the simultaneous occurrence of POP and hernia in general. Conclusion The simultaneous occurrence of inguinal hernia and female POP can lead to bladder herniation following prolapse surgery in the sense of a “locus minoris resistentiae”. Clinical examination for simultaneous signs of connective tissue weakness and counselling prior to pelvic reconstructive surgery could help to increase patients’ compliance with further surgical treatment for hernia.

scholarly journals Transvaginal natural orifice transluminal endoscopic surgery for uterosacral ligament suspension: pilot study of 35 cases of severe pelvic organ prolapse

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zhiying Lu ◽  
Yisong Chen ◽  
Xiaojuan Wang ◽  
Junwei Li ◽  
Keqin Hua ◽  
...  
Keyword(s):  
Pelvic Organ Prolapse ◽  
Pelvic Organ ◽  
Uterosacral Ligament ◽  
Uterosacral Ligament Suspension ◽  
Efficacy And Safety ◽  
Natural Orifice ◽  
Short Term ◽  
Before And After ◽  
The Mean

Abstract Background To describe the short-term outcomes of transvaginal natural orifice transluminal endoscopic surgery (vNOTES) for uterosacral ligament suspension (USLS) in patients with severe prolapse. Methods This was a retrospective study of patients with severe prolapse (≥ stage 3) who underwent vNOTES for USLS between May 2019 and July 2020. The Pelvic Organ Prolapse Quantification (POP-Q) score, Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire short form (PISQ-12) and Pelvic Floor Inventory-20 (PFDI-20) were used to evaluate physical prolapse and quality of life before and after vNOTES for USLS. Results A total of 35 patients were included. The mean operative duration was 111.7 ± 39.4 min. The mean blood loss was 67.9 ± 35.8 ml. Statistically significant differences were observed between before and after vNOTES USLS in Aa (+ 0.6 ± 1.7 versus − 2.9 ± 0.2), Ba (+ 1.9 ± 2.2 versus − 2.9 ± 0.3), C (+ 1.5 ± 2.2 versus − 6.9 ± 0.9), Ap (− 1.4 ± 1.0 versus − 3.0 ± 0.1) and Bp (− 1.1 ± 1.4 versus − 2.9 ± 0.1) (P < 0.05 for all). The mean pre- and postoperative PFDI-20 score was 19.9 ± 6.7 and 3.2 ± 5.4, respectively, and the mean pre- and postoperative PISQ-12 score was 24.8 ± 2.3 and 38.3 ± 4.1, respectively (P < 0.05 for both). During 1–13 months of follow-up, there were no cases of severe complications or recurrence. Conclusions vNOTES for USLS may be a feasible technique to manage severe prolapse, with promising short-term efficacy and safety. Larger studies with more patients and longer follow-up periods should be performed to evaluate the long-term efficacy and safety profile of vNOTES for USLS.

Sign in / Sign up

Export Citation Format

Share Document