SURGICAL TREATMENT OF URINARY INCONTINENCE AFTER VAGINAL HYSTERECTOMY Russian patent published in 2023 - IPC A61B17/42 

FIELD: medicine; operative urology; gynecology.

SUBSTANCE: oval-shaped incision is made in the mucous anterior wall of the vagina with an indent from the external opening of the urethra, which ends circulatory around the vaginal part of the cervix. The bladder is dissected from the uterus and its displacement is cranial behind the womb until the anterior fold of the peritoneum is identified. The Douglas pouch is opened, the sacro-uterine, cardinal ligaments and uterine vessels are fixed in stages, they are excised and ligated on each side, the anterior fold of the peritoneum is fixed, it is opened across, the fundus of the uterus is removed from the abdominal cavity into the surgical wound, the vaginal mucosa is sutured in the longitudinal direction with a continuous seam. The stumps of the ligaments and appendages are placed retroperitoneally on both sides. After that, the stumps of the ligaments and appendages are placed under the urethra, fixed to the right to the left internal obturator muscle of the pelvic floor, and to the left to the right internal obturator muscle.

EFFECT: method ensures prevention of recurrence of prolapse of the anterior wall of the vagina and bladder in the postoperative period by fixing the stumps of the ligaments and appendages in the form of a crossed “double-breasted frock coat” under the urethra and restoring the defect of the pelvic fascia.

1 cl, 2 ex, 5 dwg