The markedly prolapsed uterus lends itself well to vaginal hysterectomy. With such prolapse there is coexistent significant anatomic distortion of the urinary tract. Some technically important aspects of transvaginal removal of the markedly prolapsed uterus are described. Much of the surgical effort and therefore emphasis of this chapter is on reconstruction of genital tract anatomy and support.
KeywordsObstet Gynecol Bladder Neck Vaginal Hysterectomy Anterior Vaginal Wall Vaginal Vault
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- 1.Baden WF, Walker T. The anatomy of uterovaginal support. In Baden WF, Walker T (eds). Surgical Repair of Vaginal Defects. Lippincott, Philadelphia, 1991, pp 25–50Google Scholar
- 4.Nichols DH. Sacrospinous fixation for massive eversion of the vagina. Am J Obstet Gynecol 142:901–904, 1982Google Scholar
- 5.Nichols DH, Randall CL. Vaginal Surgery. (3rd ed). Williams & Wilkins, Baltimore, 1989, pp 182–238Google Scholar
- 6.Raz S. Adas of Transvaginal Surgery. Saunders, Philadelphia, 1992, pp 66–77Google Scholar
- Cruikshank SH, Kovac SR. Anatomic changes of ureter during vaginal hysterectomy. Contemp Obstet Gynecol February:38–53, 1993Google Scholar
- Heaney NS. A report of 565 vaginal hysterectomies performed for benign pelvic disease. Am J Obstet Gynecol 28:751–755, 1934Google Scholar
- Käser O, Iklé FA, Hirsch HA. In Friedman EA (ed). Vaginal hysterectomy and vaginal procedures for descensus. Atlas of Gynecologic Surgery (2nd ed). Thieme-Stratton, New York, 1985Google Scholar
- Mattingly RF, Thompson JD. TeLinde’s Operative Gynecology (6th ed). Lippincott, Philadelphia, 1985, pp 548–560Google Scholar
- Rosenzweig BA, Blumenfeld D, Bhatia NN. Incidence of urinary incontinence in asymptomatic women with severe genitourinary prolapse: a rationale for preoperative urodynamic evaluation [abstract]. In Proceedings of the Annual ACOG Meeting, 1991Google Scholar
- Reiffenstuhl G, Platzer W, Friedman EA (eds). Atlas of Vaginal Surgery: Surgical Anatomy and Technique (Vol 1). Saunders, Philadelphia, 1975, pp 286–301Google Scholar
- TeLinde RW. Prolapse of the uterus and allied conditions. Am J Obstet Gyencol 94:444–463, 1966Google Scholar
- Word BH Jr, Baden WF, Montgomery HA, Walker T. Vaginal approach to anterior paravaginal repair: alternative techniques. In Baden WF, Walker T (eds). Surgical Repair of Vaginal Defects. Philadelphia, Lippincott, 1992, pp 195–207Google Scholar