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Combine Cystocele Repair With Sling Surgery.
ST. Louis -- Early experience using cadaveric fascia lata for a combined sling procedure and cystocele repair shows promising results, Dr. Gary E. Leach said at an international conference on pelvic reconstructive and vaginal surgery.
Cadaveric fascia can be used to repair lateral, central, or combined defects of the anterior vaginal wall and provides a very strong support for the base of the bladder, said Dr. Leach, director of the Tower Urology Institute for Continence, Cedars-Sinai Medical Center, Los Angeles.
For the combined procedure, a vertical midline incision is made, followed by lateral dissection to the pubic bone. The endopelvic fascia is perforated, allowing placement of a transvaginal bone anchor.
A 6x8 cm piece of cadaveric fascia is then cut into a T shape; the upper sling portion is 2 cm wide. The sling is tied in place with Prolene sutures attached to the bone anchors.
It's important to do a very thorough physical examination before the procedure to see if there are multiple defects that should all be corrected during the same surgery, Dr. Leach said.
"We also usually get a screening renal ultrasound ...
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Source: HighBeam Research, Combine Cystocele Repair With Sling Surgery.