A young nulliparous woman has 3rd degree uterovaginal prolapse without any cystocele or rectocele. There is no stress incontinence. Uterocervical length is 3 inches. All other symptoms are normal. The best treatment plan for her will be :
Correct Answer: Shirodkar's abdominal sling.
Description: Ans. is c i.e. Shirodkar abdominal sling Abdominal sling operations are designed for young women suffering from second or third degree uterovaginal prolapse and who are desirous of retaining their childbearing and menstrual functions. The objective of these operations is to buttress the weakened suppos (Mackenrodt and uterosacral ligaments) of uterus by providing a substitute in the form of Nylone or Dacron tapes, used as slings to suppo the uterus. The operations in common practice are : Abdomino-cervicopexy Shirodkar's abdominal sling operation Khanna's abdominal sling operation. Also know : More about treatment : For young nulliparous women with 2deg or 3deg uterovaginal prolapse -- Abdominal sling operation (e.g. 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 2deg or 3deg prolapse at 28 weeks. -- Ring pessary till child bih and few weeks after and then Fothergill's repair. For < 40years multipara, desirous of retaining menstrual function and reproductive function with 2deg or 3deg 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 -- Lefo's repair For enterocele -- Moscowitz repair For vault prolapse -- Right transvaginal sacrospinous colpopexy (in obese 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 cervicopexy.
Category:
Gynaecology & Obstetrics
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