Document Detail

Pelvic floor-lifting: an interdisciplinary repair of combined rectal and vaginal prolapse-5 years experience.
MedLine Citation:
PMID:  23287886     Owner:  NLM     Status:  Publisher    
PURPOSE: Combined rectal and vaginal prolapse requires a complete repair of the pelvic floor that can only be achieved by an interdisciplinary management. We have, therefore, established a co-operation for preoperative diagnosis, interdisciplinary operations, and postoperative care involving a colorectal surgeon and a gynecologist. METHODS: Our standardized operation, which we call the pelvic floor-lifting, is a combination of well-established colorectal and gynecological operative steps and the application of surgical principles for hernia repair. A non-absorbable mesh which is used for the Wells rectopexy is used, in addition, to perform a colpopexy and also a repositioning and pre-peritoneal mesh-reinforcement of the pouch of Douglas (Douglas-lifting). The optional final step of the operation is a Burch/Hirsch colposuspension. RESULTS: We report on the satisfactory colorectal as well as gynecological results of 32 pelvic floor-lifting operations in a 5-year period. In addition, the outcomes of the operations were studied using quality-of-life questionnaires. CONCLUSIONS: The feasibility of the pelvic floor-lifting operation was demonstrated. The Douglas-lifting, which is the repair of the Douglas hernia according to surgical principles, is the best possible preventive measure against repeat pelvic floor relaxation.
Lothar Popp; Anke Augustin
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-4
Journal Detail:
Title:  Archives of gynecology and obstetrics     Volume:  -     ISSN:  1432-0711     ISO Abbreviation:  Arch. Gynecol. Obstet.     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-4     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8710213     Medline TA:  Arch Gynecol Obstet     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Clinic Dr. Guth, Juergensallee 44-48, 22609, Hamburg, Germany,
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