Sechenov University Urology Clinic uses a unique technique to help patients with enterocele: complete prolapse of the vaginal walls after the uterus is removed along with the cervix. Usually in such cases, the vagina is stitched to the sacrum through the peritoneum. Surgeons have developed an alternative technique that carries lower risks for patients and allows access through the vagina. socialbites.ca was informed about this at Sechenov University.
Enterocele is one of the types of urogenital prolapse that is characterized by complete prolapse of the vaginal walls. But unlike classical urogenital prolapse, when in the vast majority of cases the contents of the “hernia” are the uterus and bladder, with enterocele, in addition to the bladder, the main content of the hernia becomes the small intestine.
“Why small intestine? The fact is that in 99% of cases in these patients the uterus is removed due to prolapse, and in most cases it is removed along with the cervix. Removing the uterus, which involves cutting the ligaments, fascia, and veins in the vagina, not only weakens the woman’s pelvic floor but also makes room for the intestines. As a result, the vaginal walls, along with the bladder and bowel loops, continue to prolapse in the years after hysterectomy – the removal of the uterus. This is how enterocele or prolapse after hysterectomy occurs, professor Mikhail Enikeev, head of the urology department No. 2 of the Urological Clinic of Sechenov University, told socialbites.ca.
In most cases, enterocele surgery is performed from the abdominal cavity. Surgeons take the dome of the vagina, “retract” it, and sew it to the sacrum as a strong and immobile bone-attachment point. But this operation is complex, long and completely effective. The new technique involves replacing weakened ligaments and fascia with polypropylene tape through the vagina.
“Parts of the patient’s fascia are sutured to the tape using non-absorbable suture material. The operation is completed by pulling up the “arms” of the tape to restore the normal anatomy of the vaginal walls and pelvic organs. In exceptional cases, when the pelvic fascia is completely insufficient, it is replaced with a piece of polypropylene material with an area of 6×8 cm. The obvious advantages of the technique are the ease, reliability and safety of both design and construction. application technique that does not require general anesthesia and does not require placement in the patient’s abdominal cavity,” explained Enikeev.
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Source: Gazeta
Barbara Dickson is a seasoned writer for “Social Bites”. She keeps readers informed on the latest news and trends, providing in-depth coverage and analysis on a variety of topics.