Martius Labial Fat Pad procedure
Fig. 18.1 Healed labia 1 year later. Discrete scar with no bothersomeness reported by patient, including with sexual activity Image 18.1 Completed urethrolysis Step 1: A vertical incision (average 8…
Instrumentation for Native Tissue Repair Reconstructive Procedures
Fig. 2.1 Male versus female cystourethroscope tip comparison. The female tip prevents escape of irrigant and allows better urethral lumen distension Fig. 2.2 Female urethrocystoscope Fig. 2.3 Better view: Pathology…
Paravaginal Repair
Fig. 7.1 Grade II uterine prolapse (Baden-Walker), Grade III cystocele As planned, she returned for fluoroscopic urodynamic studies (FUDS) with and without vaginal packing. Post void residuals were high with…
Anterior Colporrhaphy
Fig. 6.1 Anterior vaginal wall prolapse with loss of rugal folds, more consistent with a midline defect The objective of the anterior colporrhaphy is to fold and tighten the layers…
Vesicovaginal Fistula Repair
Fig. 17.1 (a) Fistula exposure. (b) Foley catheter within fistula can apply traction. Note the inverted T incision Fistula closure— Define the fistula by blue dye test if not done…
Uterosacral Ligament Vaginal Vault Suspension
Fig. 9.1 Prolapse everted to identify the leading edge of the apex. Dimples marked The vaginal epithelium is hydrodissected away from the underlying enterocele, pubocervical and rectovaginal fascia at the…
Intraoperative Complications of Vaginal Surgery
General considerations Vaginal surgery considerations Health and ability to tolerate anaesthetic Enemas to clear the rectum Jehovah’s Witness with refusal of blood and blood products Antibiotic douches to decrease vaginal…
Autologous Fascial Sling for Female Stress Urinary Incontinence
Fig. 5.1 VCUG: Demonstrating leakage with straining Urodynamics (UDS) The urodynamic study demonstrated adequate bladder capacity of 300 ml with normal compliance, stress incontinence, and a differential valsalva leak point…
Iliococcygeus Fixation for Vaginal Vault Prolapse
Fig. 10.1 Pelvic diaphragm. The pelvic diaphragm is made up of (1) the coccygeus muscle and (2) the levator ani: the puborectalis pubococcygeus (or pubovisceral) and iliococcygeus muscles. Additional structures…
Sacrospinous Ligament Vault Suspension
Fig. 8.1 Voiding cystogram confirming presence of moderate cystocele (a) and incomplete emptying (b) The patient and the family desired a native tissue repair option for her prolapse from which…
