Uterine suspension to Pectineal Ligaments in the management of uterovaginal prolapse

• Dr V M Joshi
  Gynaecologist

Case Presentation -

           

 

 

 

 

 

 

 

                       

                     Mersilene tape fixed to uterus

The incidence of uterovaginal prolapsed in young women is high in developing countries. Weakening of uterine supports due to early child bearing and unskilled supervision of deliveries are prime causes. Preservation of uterus is of prime importance in the surgical management of these women. For young women with prolapse who desire further child bearing especially with third degree uterine prolapse, this technique, devised by Dr. V M Joshi (KEMH Pune) is an easier, safe and effective alternative to traditional operations.

Subjecting women to vaginal hysterectomy even when the family is complete may not be appropriate because of the possibility of dyspareunia, vault prolapse or psychological misgivings.

In this suspension procedure uterus is effectively elevated without compressive effect on any organ. The weight of uterus is  shared by two strong ligamentous anchoring points with the help of mersilene tape, which gives good tensile strength. This minimizes the chance of recurrence, even during pregnancy and after delivery.