PFD Week 2018-Concurrent Session #7: Microbiome/Basic Science

Video Transcription

Video Summary

This video demonstrates the transvaginal surgical management of an advanced case of pelvic organ prolapse measuring 22 cm. The patient is a 58-year-old woman with a history of five prior vaginal deliveries who presented with bothersome vaginal bulge and vaginal bleeding. The surgical technique involved a total vaginal hysterectomy, bilateral self-injectomy, utero-sacral ligament suspension, anterior and posterior repair, and cystoscopy. The prolapse was placed on a Mayo stand to decrease vaginal pressure and operative strain. The excess vaginal epithelium was dissected off and the uterus and fallopian tubes were removed. Sacrospinous ligament fixation was performed due to the inability to access the utero-sacral ligaments. The remaining prolapse was manually reduced and the vaginal epithelium was closed. Cystoscopy revealed bladder calculi, which were removed by urology. Levator ani muscles were re-approximated and an additional layer of suture was placed for perineal support. The total vaginal length measured 7-7.5 inches after the procedure. This video showcases the surgical management of advanced pelvic organ prolapse and demonstrates the steps involved in transvaginal surgery for prolapse reduction.

Asset Subtitle

Yuko M. Komesu, MD, Jenifer Nicole Byrnes, DO, Patrick M Popiel, MD, Marianne M. Ligon, Ana Rebecca Meekins, MD, Lindsey A Burnett, PhD, MD, Jonia Alshiek, MD, MSC, Oluwateniola (Teni) Brown, MD, Deanna Sinex, BS, Emily Von Bargen, DO, Jana Dopson Illston, MD, Jennifer Joy Hamner, DO, & Shweta Pai, MD

Meta Tag

Category Pelvic Organ Prolapse

Category Education

Keywords

transvaginal surgical management

pelvic organ prolapse

vaginal deliveries

vaginal bulge

vaginal bleeding

total vaginal hysterectomy

self-injectomy

utero-sacral ligament suspension

anterior and posterior repair

cystoscopy