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Vaginal Vault Prolapse Surgery

Sacrospinous colpopexy as prophylactic and therapeutic treatment of vaginal vault prolapse after hysterectomy

Authors: S. N. M. Youssif, Jamila Shahid


Affiliation:Obstetrics and Gynaecology Department, Norfolk and Norwich Hospital, Norwich

Published in: Journal of Obstetrics and Gynaecology , Volume 15, Issue 5 September 1995 , pages 311 - 315

Subject: Obstetrics, Gynecology & Women's Health

Abstract To evaluate the effectiveness of fixing the vaginal vault to the strong and immobile sacrospinous ligament when combined with traditional repairs of procidentia and vaginal vault prolapse, 20 patients with genital prolapse who needed vaginal hysterectomy and repair, or repair of vault prolapse, were studied.  Intra-operative and postoperative complications were minimal. Vaginal axis and depth were restored. Vaginal function was maintained. Discomfort was relieved. Dyspareunia did not occur. Incidence of recurrent prolapse or vaginal laxity was low when assessed after one year. All patients were satisfied.  Sacrospinous colpopexy should be added to traditional repairs to treat procidentia and with vault prolapse repairs to prevent recurrent vaginal vault prolapse.

1) Characteristic facial features

  • Flattened midface
  • Thin upper lip
  • Indistinct/absent philtrum
  • Short eye slits

2) Growth retardation

  • Lower birth weight
  • Disproportional weight not due to nutrition, height
  • Weight below the 5th percentile

3) Central Nervous System Abnormalities "neurodevelopmental"

  • Impaired fine motor skills,
  • Learning disabilities,
  • Behaviour disorders
  • Mental handicap (found in 50% of FAS)
  • To diagnose PFAS, only two of the three above criteria must be present and must include some facial features and brain differences. 
  • To diagnose ARND, only one of the above three criteria must be present and must be a brain difference. 
  • These fetal alcohol effects are often thought to be less damaging than the "full-blown" syndrome, however, they are often more debilitating to the person's quality of life. 
  • Fetal Alcohol Syndrome/Fetal Alcohol Effects are PERMANENT and cannot be outgrown.

FAS/FAE babies and young children may have other specific distinguishable features: 

  • Short stature
  • Small and thin
  • Hearing defects
  • Organ imperfections
  • Bone problems
  • Difficulty with eating
  • Difficulty developing a regular sleeping schedule
  • Difficulty learning how to walk
  • Difficulty learning toilet training
  • Impulsivity (i.e. running out into the street)
  • Hyperactivity

FAS/FAE children have learning disabilities, which include 

  • Difficulties in learning language and language use
  • Difficulties in generalizing information
  • Difficulties in mastering new or recently learned skills
  • Difficulties in recent memory (ie. yesterday events)
  • Difficulties inpredicting outcomes or cause and effect
  • Difficulties indistinguishing fact from fantasy
  • Difficulties in distinguishing friends from strangers
  • Donot learn from experience as they 
  • Do not understand cause and effect

FAS/FAE adults continue to have the same learning difficulties they had as youth, and also often have difficulty with:

  • Legal system (do not understand cause and effect)
  • Controlling alcohol consumption
  • Maintaining custody of their children
  • Mental health issues

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