Overlapping sphincteroplasty and posterior repair.

作者信息

Crane Andrea K, Myers Erinn M, Lippmann Quinn K, Matthews Catherine A

机构信息

Department of Obstetrics and Gynecology, Division of Urogynecology and Reconstructive Pelvic Surgery, University of North Carolina at Chapel Hill, 3032 Old Clinic Building, Campus Box 7570, Chapel Hill, NC, 27599, USA,

出版信息

Int Urogynecol J. 2014 Dec;25(12):1729-30. doi: 10.1007/s00192-014-2460-4. Epub 2014 Jul 8.

DOI:10.1007/s00192-014-2460-4

PMID:25001576

Abstract

INTRODUCTION AND HYPOTHESIS

Knowledge of how to anatomically reconstruct extensive posterior-compartment defects is variable among gynecologists. The objective of this video is to demonstrate an effective technique of overlapping sphincteroplasty and posterior repair.

METHODS

In this video, a scripted storyboard was constructed that outlines the key surgical steps of a comprehensive posterior compartment repair: (1) surgical incision that permits access to posterior compartment and perineal body, (2) dissection of the rectovaginal space up to the level of the cervix, (3) plication of the rectovaginal muscularis, (4) repair of internal and external anal sphincters, and (5) reconstruction of the perineal body. Using a combination of graphic illustrations and live video footage, tips on repair are highlighted.

RESULTS

The goals at the end of repair are to: (1) have improved vaginal caliber, (2) increase rectal tone along the entire posterior vaginal wall, (3) have the posterior vaginal wall at a perpendicular plane to the perineal body, (4) reform the hymenal ring, and (5) not have an overly elongated perineal body.