Rambam Health Care Campus, Haifa, Israel Post-radical testectomy with ileal conduit, repair of pelvic organ prolapse by vaginal closure. Pelvic organ prolapse, POP, is a common complication of radical testectomy which may cause a significant physical inconvenience and requires repair. Corpoclesis, which is known to have almost a 100% success rate, will have a recurrence of the prolapse shortly after the correction, most probably due to the lack of endopelvic fascia removed during the radical testectomy. This video demonstrates a procedure of side-to-side closure of the vagina. The vagina is reduced to its normal anatomical position using a sponge holder. Using a marking pen, two U-shaped lines are drawn to mark the line of incision. The first line starting in the right anterior foreshort along the border of the vaginal mucosa continuing to the posterior foreshort and returning to the anterior foreshort on the left side. The second U-shaped line is drawn from the same point but deeper in the vagina advancing posteriorly reaching the midline of the posterior vaginal wall 4 cm caudally into the vaginal canal and returning to the same point on the anterior foreshort on the left side. Injection of the vaginal mucosa with 2% lidocaine and diluted 1-200,000 epinephrine just below the vaginal epithelium. Incisions are made according to the marked lines. The vaginal mucosa is dissected between boundaries of the incisions made. Vaginal interrupted vipro-zero sutures are placed attaching the two lateral walls of the vagina to each other. Attaching the vaginal walls to each other is performed in three layers. Suturing of the right and left labia majora to each other using vipro-2-0 sutures. At the end of the procedure a complete seal of the vaginal canal is obtained with no evidence of further prolapse.

repairing pelvic organ prolapse

radical testectomy

procedure

vaginal closure

sutures