ligament suspension technique was first described by Karl Richter in 1968 and later introduced into the United States by David H.
Among them 30 women underwent Ward Mayo's operation, four underwent Sacrospinous
fixation along with Ward Mayo's operation & two underwent Sacrocolpopexy [Table 4].
A 65-YEAR-OLD WOMAN underwent anterior and posterior colphorrhaphy to repair a cystocele and rectocele, sacrospinous
ligament fixation for vaginal prolapse, and a TVT mid-urethral suspension procedure to correct stress urinary incontinence.
Apical attachment can be accomplished through a sacrocolpopexy, uterosacral ligament suspension, or sacrospinous
The gynecologist used transvaginal sutures to attach the mesh to the sacrospinous
If the prolapse stems predominantly from a loss of apical support, treatment can be addressed through one of several procedures, from a sacral colpopexy to a uterosacral suspension or a sacrospinous
vaginal vault suspension.
Through the posterior compartment, the mesh can be attached to the sacrospinous
ligament (SSL), enabling true level-one support.
Since Shull described this procedure, numerous published studies have demonstrated outcomes similar to other vaginal suspension procedures, such as sacrospinous
Any filmy tissue on the sacrospinous
ligament should be wiped away medially from the ischial spine at this point.
A gynecologic surgeon performed mesh repair of the prolapse, and cystocele repair with bilateral sacrospinous
ligament fixation and a prepubic transvaginal sling.
The new "Elevate" procedures attach to the sacrospinous
ligaments about two centimeters from the spinous process and demonstrate consistent posterior/apical support.
C, performed the sacrospinous
vaginal vault suspension, which included placement of two sutures.