2nd Global Virtual Summit On Gynecology, Obstetrıcs & Women’s Health., Oregon, United States Of America, 20 - 21 September 2021, pp.16
Objective: To show how uterine prolapsus in a patient with ureteral kinking could be safely managed
with a laparoscopic pectopexy.
Design: Stepwise demonstration of the technique with narrated video footage.
Setting: Anatomical support of the uterus is provided primarily by the pelvic diaphragm and then
by the cardinal and sacrouterine ligaments . Compression of the ureters due to uterine prolapse,
and bilateral hydronephrosis is not a common clinical condition . Uterus-sparing procedures aims to
correct apical prolapse by attaching the lower uterus or cervix to a support structure . Advantages
of uterus-sparing prolapse correction techniques are a shorter operative time and less blood loss, but
other advantages remains unproven. Laparoscopic pectopexy is an effective and alternative procedure
for women with pelvic organ prolapse. This promosing surgical technique cold be an alternative
to sacrocolpopexy procedure . In this case report, we present the successful management of
laparoscopic pectopexy in a woman with ureteral kinking and hydronephrosis due to uterine prolapse.
Interventions: Laparoscopic approach to an advanced pelvic organ prolapse with several key
strategies to maintain anatomic correction:
1. Suspension of cervix uteri to pectineal ligament
2. Vaginal evaluation of adequacy of the pectopexy
3. Correction of ureteral kinking
Conclusion: Advanced pelvic organ and bladder could be managed with laparoscopic conservative surgery.