METHOD FOR TREATMENT OF ANTERIOR APICAL PROLAPSE USING XENOGENIC BIOMATERIALS Russian patent published in 2024 - IPC A61B17/42 A61F2/02 

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to operative urogynecology. Plastic surgery of the anterior vaginal wall is performed, during which infiltration is carried out under the mucous membrane of the vagina into the underlying tissues and paravaginal spaces on both sides of 80 ml of a mixture of 0.9% 400 ml sodium chloride solution with 1 ml adrenaline. A linear incision of the mucous membrane of the anterior wall of the vagina is made, retreating up to 1.5 cm from the outer opening of the urethra, the mucous membrane is peeled off in both directions, the excess is cut off, the posterior wall of the bladder is separated from the cervix along the middle line, lifted up, correction of antero-apical prolapse is performed. In this case, a trapezoidal flap is cut out of the xenopericardial mesh, where the wide base of the flap is equal to the distance between the upper corners of the separated fascia of the bladder, the height of the flap is equal to the distance from the urethra to the cervix, the narrow base of the flap is equal to the width of the cervix. The flap is placed on the fascia of the bladder and fixed with separate nodular sutures, a non–absorbable 2-0 Ethibond thread, 75 cm at 6 points: the first point is the upper–right angle - between the inner surface of the mucous anterior wall of the vagina and the fascia of the bladder, the second point is the upper-left angle - between the inner surface of the mucous anterior wall of the vagina and the fascia of the bladder, the third point is the lower-right the angle is between the inner surface of the mucous membrane of the anterior vaginal wall and the fascia of the urinary tract, the fourth point is the lower left corner – between the inner surface of the mucous membrane of the anterior wall of the vagina and the fascia of the bladder, the fifth point is on the fascia of the bladder 2 cm below the outer opening of the urethra along the midline, the sixth point is on the fascia of the bladder at the level of the isthmus along the midline. In this case, all seams are applied 2-3 mm from the edge of the xenopericardial mesh. EFFECT: method allows to reduce the number of intraoperative and postoperative complications in the form of erosion of the bladder wall and vaginal walls, implant rejection, formation of vesicovaginal fistulas, displacement of the prosthesis, purulent-inflammatory complications, and reduce the frequency of recurrence.

1 cl, 6 dwg, 2 ex