抄録
Pelvic organ prolapse (POP) patients present various clinical findings. It is important to diagnose and repair the injured parts of the pelvic floor in each POP patient. The appropriate surgical procedure should be performed for each patient with considering their age, occupation, and life habits. We report a case that presented severe POP with large vaginal mucosal defect and underwent laparoscopic uterosacral colposuspension. She was 75 years old woman, gravid 4, para 1, with severe POP. She complained anuresis and had felt a sense of discomfort soon after the spontaneous delivery 30 years ago. Initially, TVM (tension-free vaginal mesh) operation was planned after curing the vaginal mucosal defect. The ring pessary insertion and estrogen/progesterone administration were performed. Unfortunately, anuresis and pyelonephritis occurred repeatedly and surgical treatment must be given emergently. We performed laparoscopic hysterectomy and vaginal vault suspension by using uterosacral ligaments (Shull's method). The advantages of this operation are low risk of ureter injury, firm colposuspension, completion with basic gynecologic laparoscopy, and no need for mesh. The patient discharged after 7 days after the operation without any complications and no recurrence has confirmed for three months after the operation. This operation will be one of the useful POP procedure.
