Vaginal prolapse can occur due to stretching or damage of the uterosacral ligaments. Laparoscopic uterosacral colpopexy is done by a plication (bringing together) and elevation of the ligaments with sutures. This corrects the stretching and damage of the ligaments, resulting in an elevation of the vagina and correction of the prolapse. This also results in a lengthening of the vagina.
In women who also have a rectocele, a posterior colporrhaphy is performed at the time of the uterosacral colpopexy. Posterior colporrhaphy involves a plication of the supportive tissue between the rectum and vagina which reduces a bulge of the back side of the vagina.
For symptoms of “vaginal looseness,” perineoplasty or vaginal rejuvenation involving a tightening of the vagina is also performed.
Optimal treatment is based on each individual patient’s history, her desired outcome and a physical exam.
Listen to Dr. Shashoua narrate a video of uterosacralcolpopexy for pelvic organ prolapse. da Vinci Uterosacralcolpopexy and supracervical hysterectomy.
Disclaimer: Due to the graphic nature of the video, it may not be suitable for all viewers.