Universität zu Köln

Ludwig, Sebastian, Morgenstern, Bernd, Mallmann, Peter and Jaeger, Wolfram (2019). Laparoscopic bilateral cervicosacropexy: introduction to a new tunneling technique. Int. Urogynecol. J., 30 (7). S. 1215 - 1218. LONDON: SPRINGER LONDON LTD. ISSN 1433-3023

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Abstract

Introduction and hypothesisTo elevate and suspend the apical end of the vagina, the uterosacral ligaments (USL) were replaced by polyvinylidene fluoride (PVDF) structures. These PVDF structures were placed in the peritoneal folds of the USL at the pelvic wall to mimic the lateral and backward tension and to avoid rectal obstruction. A special tunneling device was used, which allowed the semi-circular placement of the structure without destroying the peritoneum.MethodsA 59-year-old woman with mixed urinary incontinence and apical prolapse (pelvic organ prolapse quantification system, POP-Q, stage 2) of the uterus underwent laparoscopic bilateral USL replacement. USLs were replaced by PVDF structures by performing the cervicosacropexy (CESA) technique using a semi-circular tunneling device.ResultsApical support was restored (POP-Q stage 0), and the patient was continent thereafter. The tunneling device was pulled through the peritoneal folds of the USLs toward the cervix. The new USL structures were brought to their physiological position. The new technique did not lead to any complications and did not cause any side effects during 1-year follow-up.ConclusionsRestoration of apical prolapse and urinary continence was achieved by bilateral USL replacement using a semi-circular tunneling device that was inserted through the lateral abdominal trocar incision.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Ludwig, Sebastian UNSPECIFIED UNSPECIFIED UNSPECIFIED Morgenstern, Bernd UNSPECIFIED UNSPECIFIED UNSPECIFIED Mallmann, Peter UNSPECIFIED UNSPECIFIED UNSPECIFIED Jaeger, Wolfram UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-136777
DOI:	10.1007/s00192-019-03911-2
Journal or Publication Title:	Int. Urogynecol. J.
Volume:	30
Number:	7
Page Range:	S. 1215 - 1218
Date:	2019
Publisher:	SPRINGER LONDON LTD
Place of Publication:	LONDON
ISSN:	1433-3023
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language PELVIC ORGAN PROLAPSE; URINARY-INCONTINENCE Multiple languages Obstetrics & Gynecology; Urology & Nephrology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/13677