Explain: Pelvic relaxation syndrome

Content: Posterior colporrhaphy

 

Clinical Information:

The female patient had bearing down sensation, back soreness and lower abdominal pain for years. Palpable protruding prolapsed [[uterus, vaginal wall]] was noted.

ICS staging {{I, II, III, IV}}.

Urodynamic study {normal finding, GSI, D.I., mixed incontinence, not done}} was noted.

Pad test :        gm.

Menopause {{ +, -}}.

Hormone replacement therapy: {{yes, no}}

Urogynecologic ultrasonography {{ +, -}}.

Previous pelvic surgical history: [[no, Burch, Laparoscopic Burch, EBNS, Raz, Stamy, TVT, anterior colporraphy, posterior colporraphy, VTH, colposacropexy, S-S ligament suspension, others]]       

 

Operative Procedures:

Type of operation: Posterior colporraphy [[VTH, anterior colporraphy, posterior colporraphy, EBNS, Raz, Stamy, TVT]].

Two Allis clamps are placed at the junction of each labium minus with the vaginal mucosa and strong outward traction made then a thin piece of the muco-cutaneous tissue is excised. The posterior vaginal mucosa is then separated from the underlying fascia for 5‑6 cm, and laterally for 3‑4 cm. Two 2-0 chromic interrupted surgical gut sutures are placed in the levator ani muscles, and tied. After this, the vaginal mucosa is pulled downward and the excess vaginal tissue is cut away with scissors. A continuous 2-0 chromic surgical gut suture is begun a little above the top of the incision in the vaginal mucosa, until it reaches the entrance of the vagina. The rest of the incision is closed by means of a continuous 2-0 chromic surgical gut suture.

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Operative Findings:

Cystocele grade {{ I, II, III }}

Rectocele {{ I, II, III }}

Enterocele{{ +, -}}

ICS staging {{I, II, III, IV}}.

{{Uterine prolapse, Vaginal cuff eversion}}: {{ I, II, III }}

 

Complication: [[massive bleeding, ureter injury, bladder injury, intestine injury, _______________]].

 

Dr:________________. Date: _______________.