Dr Jenny Cook

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Pelvic Prolapse

Uterine Prolapse - Rectocele

Symptoms

A 68 year old woman presented with uterine prolapse and a rectocele.

Diagnosis

Uterine prolapse and rectocele.

Procedure

She underwent a Subtotal Laparoscopic Hysterectomy (the cervix was conserved). The vaginal apex is then supported – a Laparoscopic Mesh Sacral Colpopexy. The two arms of the mesh are sutured to the anterior and posterior cervix. The mesh is then tacked to the sacral promontory. A Vaginal Posterior Repair is performed.

Outcome

The patient made an excellent recovery. Follow up confirmed the vagina was well supported.

The laparoscopic view of the pelvis at the start – uterus, ovaries and tubes (incidentally, there is a clip on the right Fallopian Tube for sterilisation)

The mesh is tacked into the Sacral Promontory

A Laparoscopic Hysterectomy has been performed. The mesh is now sutured laparoscopically to the cervical stump
 

The peritoneum is closed over the mesh

The pelvis at the end of the procedure