Saturday, 28 December 2013

Prolapse Treatment

For young nulliparous women with 2' or 3' uterovaginal prolapse
-Abdominal sing operation Cervicopexy (eg. Purandare, shirodkar, Khanna)

For a parous women in early weeks of pregnancy
-Ring pessary in the first trimester of pregnancy.

For a parous women in pregnancy with 2° or 3° prolapse at 28 weeks.
-Ring pessary till child birth and few weeks after and then Fothergirs repair.

For < 40 years multipara, desirous of retaining menstrual function and reproductive function with 2° or 3° prolapse.
-Fothergill's repair

For women > 40 years completed family size
-Mayoward's vaginal hysterectomy (with ant. Colporrhaphy and posterior colpoperineorrhaphy) with pelvic floor repair

For elderly menopause patient with advanced prolapse
-Lefort's repair

For enterocele
-Moscowitz repair

For vault prolapse
-Right sacrospinous colpopexy (in o and elderly not fit for abdominal surgery).
-Transabdominal sacral colpopexy using Mersilene mesh extraperitoneally in patient fit for abdominal surgery).
Congenital prolapse of uterus/ Nulliparous prolapse without cystocele:
- Purandare's cervicopeoy

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