The Manchester–Fothergill and the Elevate Posterior? technique for the correction of a cervical elongation and large enterocele in a patient with bladder exstrophy and multiple surgeries

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• 作者：M. Luisa Sánchez Ferrer ; Eduardo Bataller Sánchez…
• 关键词：Bladder exstrophy ; Pelvic organ prolapse ; Surgical technique ; Elevate Posterior? ; Manchester–Fothergill operation
• 刊名：International Urogynecology Journal
• 出版年：2015
• 出版时间：August 2015
• 年：2015
• 卷：26
• 期：8
• 页码：1239-1242
• 全文大小：105 KB
• 参考文献：1.Bartelink LR, Feitz WF, Kluivers KB, Withagen M, Vierhout ME (2011) Surgical treatment of uterine prolapse in women with bladder exstrophy: report of two cases with modified Prolift procedure. Int Urogynecol J 22:889-91PubMed Central PubMed View Article
  2.Nakhal RL, Deans R, Creighton S, Wood D, Woodhouse C (2012) Genital prolapse in adult women with classical bladder exstrophy. Int Urogynecol J 23:1201-205PubMed View Article
  3.Anusionwu I, Baradaran N, Trock BJ, Stec AA, Gearhart JP, Wright EJ (2012) Is pelvic osteotomy associated with lower risk of pelvic organ prolapse in postpubertal females with classic bladder exstrophy? J Urol 188:2343-346
  4.Benson AD, Kramer BA, McKenna PH, Schwartz BF (2010) Robot-assisted laparoscopic sacrouteropexy for pelvic organ prolapse in classical bladder exstrophy. J Endourol 24:515-19PubMed View Article
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  6.Ebert AK, Falkert A, Brandl R, Hirschfelder H, Koller M, R?sch WH (2009) Pelvic-floor imaging using three-dimensional ultrasonography and magnetic resonance imaging in the long-term follow-up of the bladder exstrophy-epispadias complex. BJU Int 105:248-53PubMed View Article
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  8.Castagnetti M, Berrettini A, Zhapa E, Rigamonti W, Zattoni F (2011) Issues with the external and internal genitalia in postpubertal females born with classic bladder exstrophy: a surgical series. J Pediatr Adolesc Gynecol 24:48-2PubMed View Article
  9.Kwong YT, Knoepp LR, Wright EJ 3rd, Chen CC (2012) Recurrent pelvic organ prolapse in a patient with history of bladder exstrophy. Female Pelvic Med Reconstr Surg 18:63-5PubMed View Article
  10.Dietz V, van der Vaart CH, van der Graaf Y, Heintz P, Schraffordt Koops SE (2010) One-year follow-up after sacrospinous hysteropexy and vaginal hysterectomy for uterine descent: a randomized study. Int Urogynecol J 21:209-16PubMed Central PubMed View Article
  
• 作者单位：M. Luisa Sánchez Ferrer (1)
  Eduardo Bataller Sánchez (2)
  Laura Hernández Hernández (1)
  Francisco Machado Linde (1)
  Ana Isabel Hernández Pe?alver (1)
  Aníbal Nieto Díaz (1)
  
  1. Department of Gynecology and Obstetrics, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain
  2. Department of Gynecology and Obstetrics, Hospital Clinic, Barcelona, Spain
  
• 刊物主题：Gynecology; Urology/Andrology;
• 出版者：Springer London
• ISSN：1433-3023

文摘

Introduction and hypothesis A 60-year-old woman presented with congenital bladder exstrophy, urinary incontinence since birth, and pelvic organ prolapse since the menopause at the age of 46?years. Methods The patient (gravida 2, para 2 by cesarean sections and tubal ligation) described an extensive past surgical history that included epispadias and neourethral procedures, anti-reflux surgery using the Lich–Grégoir technique, bilateral ureterosigmoidostomy achieving continence, uterine fixation after the Doléris operation, and neovaginal reconstruction. The physical examination revealed a fourth-degree enterocele with cervical elongation (POP-Q: Aa-2, Ba-2, C--, D--, gh:5, pb:2.5, Tvl:6, Ap--, Bp +6). Gynecological ultrasound and uro-CT were performed to ensure that the ureterosigmoidostomy had been successful, and CT-based 3D bone reconstructions were obtained to calculate the distance between the pubic rami and the ischial spines. Based on a literature review of the management options for these patients and the specific characteristics of our patient, a decision was made to perform trachelectomy (the Manchester technique with Fothergill stitches) and a polypropylene mesh placement with sacrospinous ligament anchor (Elevate Posterior? PC, AMS). Results Six months after the surgery, we observed good anatomical and functional results with significant improvement in the patient’s quality-of-life scale score. Conclusion We believed that the vaginal approach was minimally invasive with a low risk of morbidity in our patient, who had a very altered anatomy, but produced a satisfactory functional result.