Transvaginal Uterine Suspension is a skill most OBGYNs did not get trained in. Today’s resident will probably not get to do one of these and it is the Urogyn Fellow who gets the exposure to do these. If there is a prolapse of uterus down the vagina to show itself as a visible cervix at the introitis then a hysterectomy was usually done. Vaginal hysterectomy is the preferred approach in most cases. Nowadays, a laparoscopic approach with lots of tummy holes are done.
I want to show another option available for those who want to do an outpatient uterine suspension using a Dermal Allograft. I use the sacrospinous ligaments bilaterally as my anchor sites to secure a cadaver dermal graft that has been sutured to the cervix. This is a wonderful solution if there is also a significant cystocele present. In fact, if there is a cystocele and a rectocele to repair, I can attach the cervix to the dermal graft then suspend those to the SSL from the anterior and posterior approaches. Success rates are high and morbidity is low. This video shows you a case where I cut the shape of the dermis by hand. I will show one at a later date showing a pre-cut dermis called VNew.
I hope you have enjoyed this newsletter and have learned some new things to help your practice. I always welcome your input and inquiries. Email me directly. Tell your colleagues of this resource on Cosmetic Gynecology.
This is a great solution for patients who do not want a hysterectomy.
Many other pelvic reconstruction videos using augmented repair techniques are found on my Gynflix Online e-Learning platforms that you can join. A major upgrade is just around the corner for Gynflix. Be sure to subscribe.
Red Alinsod, MD (red@alinsodinstitute.com, www. alinsodinstitute.com,www.gynflix.com)Social Media:
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