title: Surgical reinforcement of support for the vagina in pelvic organ prolapse: concurrent iliococcygeus fascia colpopexy (Inmon technique).
abstract: To reinforce the support of the vagina, concurrent use of iliococcygeus fascia colpopexy with the McCall culdeplasty was scheduled for primary uterine prolapse. Forty-five women with primary uterine prolapse without stress urinary incontinence were treated by McCall culdeplasty alone or McCall culdeplasty plus iliococcygeus fascia colpopexy for suspension of the upper portion of the vagina. Recurrence of vaginal support defects were carefully followed for 15-50 months. Additional iliococcygeus fascia colpopexy did not change with the axis of the vagina obtained by McCall culdeplasty, although it prolonged total operation time by 32 min and increased blood loss by 94 ml. Two cases (8.3%) had postoperative vaginal defects in the group undergoing combined procedures and seven recurrent cases (33.3%) were observed in the group undergoing McCall culdeplasty alone. The durability of the combined procedures was superior to that of the modified McCall culdeplasty alone by Kaplan-Meier analysis. These results suggest that iliococcygeus fascia colpopexy is reasonably safe and strengthens not only the attachment of the upper part of the vagina but also that of the anterolateral vaginal wall.
authors.affiliation: Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Suita, Japan. mkoyama@gyne.med.osaka-u.ac.jp
authors.forename: Masayasu
authors.initials: M
authors.lastname: Koyama
authors.forename: Susumu
authors.initials: S
authors.lastname: Yoshida
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Koyama
authors.forename: Kazuhide
authors.initials: K
authors.lastname: Ogita
authors.forename: Tadashi
authors.initials: T
authors.lastname: Kimura
authors.forename: Koichiro
authors.initials: K
authors.lastname: Shimoya
authors.forename: Yuji
authors.initials: Y
authors.lastname: Murata
authors.forename: Ichiro
authors.initials: I
authors.lastname: Nagata
mesh_terms: D000368:Aged; D000071938:Fasciotomy; D005260:Female; D006801:Humans; D008022:Ligaments / Q000601:surgery; D008875:Middle Aged; D019106:Postoperative Hemorrhage; D012008:Recurrence; D012445:Sacrococcygeal Region / Q000601:surgery; D013536:Suture Techniques; D016896:Treatment Outcome; D014596:Uterine Prolapse / Q000601:surgery*; D014621:Vagina / Q000473:pathology / Q000601:surgery*