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It is an operation for uterine prolapse by fixation of the cardinal ligaments. Its purpose is to reduce the cystourethrocele and to reposition the uterus within the pelvis. The major steps of the intervention are listed below: Preliminary dilatation and curettage; Amputation of cervix
The uterosacral ligaments (or rectouterine ligaments [1]) are major ligaments of uterus that extend posterior-ward from the cervix to attach onto the (anterior aspect of the [2]) sacrum. [ 3 ] Structure
The uterus is held in position within the pelvis by ligaments, which are part of the endopelvic fascia. These ligaments include the pubocervical ligaments, the cardinal ligaments, and the uterosacral ligaments. It is covered by a sheet-like fold of peritoneum, the broad ligament. [5]
Following Alwin Mackenrodt's 1895 publication of a comprehensive description of the female pelvic floor connective tissue, Fothergill began working on the Manchester-Fothergill surgery with the belief that the cardinal and uterosacral ligaments were key support structures for the uterus. [15]
Vaginal prolapse or uterine prolapse may occur in women when other pelvic ligaments and supportive structures are weakened. One treatment is sacrospinous fixation.In this surgery, the apex of the vagina is sutured to the sacrospinous ligament, which may offer a sturdier support than weakened pelvic ligaments, ideally preventing further prolapse.
Rarely, fibroids are found in the supporting structures (round ligament, broad ligament, or uterosacral ligament) of the uterus that also contain smooth muscle tissue. Since 2011 the FIGO published their consensus paper on the classification of fibroids, namely from 0 to 8.
This is accomplished by bringing the edges of the vagina together and suturing them together and to the uterosacral ligaments to prevent prolapse. The peritoneum is also sewn into the newly created vaginal cuff. [1] There may be an advantage to using one method of closure over another. [3]
The rectouterine (or recto-uterine) pouch is also called the rectouterine excavation, uterorectal pouch, rectovaginal pouch, pouch of Douglas (after anatomist James Douglas, 1675–1742), Douglas pouch, [6] Douglas cavity, [6] Douglas space, [6] Douglas cul-de-sac, [6] Ehrhardt–Cole recess, Ehrhardt–Cole cul-de-sac, cavum Douglasi, or excavatio rectouterina.