E-Posters-Modified High McCall Vaginal Cuff Suspension for Stage 3-4 Uterine Prolapse at the time of Vaginal Hysterectomy - Importance of High Uterosacral/Cardinal Ligament Vault Suspension and Meticulous Closure of Large Levator Hiatal Defects

Modified High McCall Vaginal Cuff Suspension for Stage 3-4 Uterine Prolapse at the time of Vaginal Hysterectomy - Importance of High Uterosacral/Cardinal Ligament Vault Suspension and Meticulous Closure of Large Levator Hiatal Defects - Ariel Zilberlicht, MD

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The objective of this study was to evaluate the long-term results of a modified high McCall culdoplasty technique for stage 3-4 uterine prolapse during vaginal hysterectomy. The researchers aimed to assess the success rate of this technique without the need for additional sacrospinous fixation.<br /><br />METHODS<br /><br />This retrospective clinical study was conducted between 2000 and 2017 at a urogynecology center. Standardized questionnaires and examinations were used for initial evaluation and follow-up, using the POP-Q or Baden-Walker system. All surgeries were performed by the same surgeon or under his supervision.<br /><br />RESULTS<br /><br />Out of 219 cases found, 176 met the inclusion criteria. The mean follow-up period was 19.35 months. Recurrence of stage 2 or above was diagnosed in 25 cases (14%), with 19 (76%) being asymptomatic. The recurrences primarily occurred at the anterior wall (48%) and posterior wall (25%), with some involving multiple compartments. Only 3% of the cases required further surgery, all of which had recurrent enterocele.<br /><br />CONCLUSIONS<br /><br />The modified McCall technique for vault suspension during hysterectomy for advanced pelvic organ prolapse had a good long-term success rate without the need for sacrospinous fixation. Only a small percentage of cases required further surgery for symptoms, which were primarily related to recurrent enterocele. The authors emphasized the importance of high uterosacral/cardinal ligament vault suspension and meticulous closure of large levator hiatal defects for successful surgical outcomes in procidentia repair.

Meta Tag

Concept Modified High McCall Culdoplasty

Concept Pelvic Organ Prolapse

Concept Recurrence

Concept Vaginal Cuff Suspension

Concept Uterine Prolapse

Keywords

McCall culdoplasty technique

uterine prolapse

vaginal hysterectomy

long-term results

sacrospinous fixation

retrospective study

recurrence

anterior wall

posterior wall

pelvic organ prolapse

Modified High McCall Culdoplasty

Pelvic Organ Prolapse

Recurrence

Vaginal Cuff Suspension

Uterine Prolapse