The goal in surgically correcting prolapse defects is to restore normal anatomical support as a mean to enhancing function with the end results of improving patient symptoms and quality of life.
Pelvic organ prolapsed is a common problem reported in up to 50% of parous women, which is a medical condition that the bladder, uterus, vagina, and/or rectum descend from their normal positions within the pelvis. These organs can sometimes protruding through the opening of the vagina. In may associated with protrusion symptoms and complicit with voiding, defecatory, and sexual dysfunction. Quality of life is also impacted by pelvic organ prolapsed.
Sarcrocolpopexy has been the most important operation for repair of enterocele and vaginal vault prolapse. In may also be utilized for apical support with concurrent hysterectomy. Suspension of the vaginal apex to the anterior longitudinal ligament overlying the sacral promontory is performed. The procedure may be approached abdominally, laparoscopically, or robotically.
Under scopy, the peritoneum over the first sacral joint is opened to exposure the anterior longitudinal ligament and middle sacral vessels. Then, the peritoneum over the vagina is opened to develop the rectovaginal and vesicovaginal spaced. Once these spaces are opened and the bladder and rectum are mobilized, an assessment is made of length for the mesh arms. Y-shaped mesh with a tail is attached to the sacrum with two or three sutures and make a permanent suture through the full thickness of the anterior and posterior vaginal wall. The peritoneum is then closed over the mesh to cover the bridge of mesh between vaginal apex and sacrum in an attempt to decrease the risk of adhesion and bowel obstruction.
Risk and complication
- Bladder, ureter and bowel injury
- Recurrent prolapsed
- Urinary tract infection
- Mesh exposure/erosion
- Urinary incontinence
The procedure cost is about 640,000-690,000 NTD, prices are subject to change without prior notice, need to pay in accordance with the actual medical expenses.