METHOD OF SURGICAL TREATMENT OF POSTERIOR VAGINA WALL PROLAPSE IN WOMEN, LIVING SEXUAL LIFE Russian patent published in 2013 - IPC A61B17/42 A61F2/02 

FIELD: medicine.

SUBSTANCE: substance: invention relates to operative gynecology and can be applied in treatment of women, living sexual life with posterior vagina wall prolapse. For this purpose reconstruction of posterior part of pelvis floor is realised. For this purpose two diametrical cuts of posterior vagina wall mucous membrane are preliminarily performed: on in the area of posterior commissure and second with 3-4 cm indent from external orifice of uterus cervix. Tunnel is formed by separation of tissues between rectovaginal septum and anterior wall of rectum with preparation scissors. Placement of mesh implant is realised through formed tunnel, with two proximal branches being passed through medial parts of sacrospinal ligaments and brought out on skin of perineum more laterally and lower than anus by means of guides. Two distal branches of implant are passed from two sides through muscle, lifting anus, and is brought on skin of perineum more laterally than posterior commissure by means of guide. After smoothing net implant in formed tunnel on surface of rectum, free ends of implant are fixed to posterior labia of uterus cervix in projection of internal orifice by non-absorbable sutures, without puncturing uterus cervix mucosa, and to tendious center of perineum in the area of posterior commissure of perineum; excess of free ends of branches is cut off subcutaneously and submerged into tissues; vaginal wall is sutured with uninterrupted absorbable suture, skin cuts in the area of perineum are sutured with interrupted sutures.

EFFECT: method makes it possible to ensure effective treatment of patient living sexual life with prolapse of posterior vagina wall by creation of neo-fascia instead of destroyed one, which is ensured due to definite method of placement and fixation of mesh implant in formed sub-mucous membrane tunnel, which contributes to reduction of dyspareunia, associated with scar in vagina, as well as due to application of mesh implant made lighter as a result of definite structure.

1 dwg, 3 ex