Clinical study of the sacrospinous ligament suspension using Miya hook in management of pelvic organ prolapse / 대한산부인과학회잡지

OBJECTIVE: To assess the results of the sacrospinous ligament suspension using Miya hook for the treatment of uterovaginal prolapse or vault prolapse following hysterectomy. METHODS: Between October 1997 and December 2000, in Kyung Hee Medical Center, 50 pelvic organ prolapse patients underwent vaginal hysterectomy and sacrospinous ligament suspension or sacrospinous ligament suspension only. We evaluated age, parity, operation time, recovery time, duration of hospitalization, change of Hemoglobin level, number of vaginal delivery, type of prolapse, and complications. RESULTS: Forty-four patients (88%) had uterine prolapse and six patients (12%) had vaginal vault prolapse. All patients underwent sacrospinous suspension and anterior-posterior colporraphy in which forty-one patients (82%) underwent concomitant vaginal hysterectomy. There has been one failure case. And then repeat sacrospinous ligament suspension with anterior and posterior vaginal repair was performed successfully. Recurrent prolapse hasn't been developed yet. Most common problems were transient voiding difficulty and vague buttock pain. CONCLUSION: The sacrospinous ligament suspension is considered to be effective and safe in the treatment of vault and uterine prolapse. It avoids major abdominal surgery and allows the surgeon to correct coexistent cystocele and rectocele.

The 2 Cases of the Sacrospinous Ligament Fixation for the Massive Eversions of the Vagina after Total Abdominal Hysterectomy / 대한산부인과학회잡지

Massive eversion of the vagina is one of the most disturbing disorders confronting a woman. It is a complex disorder that always surgical, and all defects. The managements is always surgical, and all defects must be repaired concomitantly. Current surgical practice relies primarily on the strength of the endopelvic fascia and certain ligaments. Massive eversion of the vagina can be treated by a variety of transvaginal and transamdominal surgical technique. In most instances a transvaginal approach is useful. If strong cadinal and uteroscral support in not available fiocation of the vginal vault to the sacrospinous ligment is useful. In 1987, Miyazaki introduced his Miya Hook ligature carrier. With this instrume nt, introduction of the needle became safer and easier than with the Deschamp aneurysm needle. We had experienced two cases of massive eversion of vagina after the total abdominl hyst erectomy who were treated succesfully with sacrospinous ligement fixation by using Miya Hook. We report above two cases and review briefly.