PFD Week 2016-Recurrent Apical Prolapse After Laparoscopic Sacrocolpopexy: Where Did It Go Wrong?

Recurrent Apical Prolapse After Laparoscopic Sacrocolpopexy: Where Did It Go Wrong?

Video Transcription

Video Summary

This video discusses a rare case of recurrent apical prolapse after sacrocervicalpexy surgery. The patient underwent a sacrocervicalpexy for stage 2 prolapse but re-presented with recurrent bulge and stage 3 cervical prolapse after two years. Surprisingly, the lightweight polypropylene mesh used in the procedure had failed in the middle of the sacral extension. The surgeon decided to re-do the sacrocervicalpexy using an intervening permanent polypropylene mesh. The video demonstrates the procedure, including opening the peritoneum, freeing up the torn mesh segment, dissecting the bladder and rectovaginal space, and suturing the new mesh to the anterior vaginal wall and cervix. The patient was advised to prevent constipation and refrain from lifting after the surgery.

Asset Subtitle

Peter L. Rosenblatt, MD, FACOG

Keywords

recurrent apical prolapse

sacrocervicalpexy surgery

polypropylene mesh

stage 3 cervical prolapse

permanent polypropylene mesh