Laparoscopic sacral uteropexy with cravat technique-Experience and results

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Abstract

Objective: The aim of the present study was to evaluate the safety and efficacy of a "Cravat'' technique for the management of uterine prolapse in patients who want to preserve uterus, involving suspension of the uterus from the sacral promontory by using polypropylene mesh. Materials and Methods: A prospective observational study between January 2011 and September 2013 was conducted. Prior to surgery, prolapse assessment was undertaken with Baden-Walker halfway system to grade the degree of prolapse at all sites. Patients with severe uterine prolapse (stage II-IV) who want to preserve uterus, were operated with Cravat technique. All patients were evaluated at 2 weeks and 6 weeks after surgery and followed for 6 months. Outcomes were evaluated objectively by vaginal examination using Baden-Walker halfway classification, and subjectively classifying patients as 'very satisfied', 'satisfied' and 'not satisfied' at the 6th month postoperatively. Results: Sacral uteropexy was successfully performed by laparoscopy in 32/33 patients (one needed to be converted to laparotomy). Nine patients also had a concurrent procedure as colporaphy anterior, colporaphy posterior or transobturator tape. Postoperative recovery has been uneventful with subjective and objective cure rates were 96.9% and 93.9%, respectively at six month. One recurrence of total prolapse needed to be reoperated and two patients with sacrouteropexy still remained at stage 2 prolapse. There have been no cases of graft exposure, rejection or infection with a median follow-up of 23.9 months. Conclusions: Laparoscopic sacral uteropexy with "Cravat technique" was found to be safe and simple procedure.

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APA

Api, M., Kayatas, S., Boza, A., Nazik, H., & Aytan, H. (2014). Laparoscopic sacral uteropexy with cravat technique-Experience and results. International Braz J Urol, 40(4), 526–532. https://doi.org/10.1590/S1677-5538.IBJU.2014.04.12

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