SURGICAL CL/USL REPAIR USING VERTICAL INCISIONS
VIDEO repair CL/USL with vertical vaginal incisions using No2 polyester sutures.
Vertical incisions are more familiar for those familiar with the traditional Manchester operation. The surgical methodology as regards dissection and ligament repair is identical to that for transverse incisions. The vertical CL operation repairs a high cystocele (transverse defect) and reconstructs the CLs of the prolapsed uterus exactly as does the transverse incision. The cervix is grasped with a tenaculum. A full thickness vertical incision is made from cervix to 1cm short of the bladder neck. The bladder is dissected off the vagina and cervix. CLs are identified and approximated with No2 polyester sutures.
A central defect is higher up, just below bladder neck, fig6. excess vaginal tissue is not excised, but repaired by the vaginal conservation technique, fig 7.