This chapter should be cited as follows: A circumferential suture Fig. Attaching the vagina with an abdominal sacrocolpopexy or through vaginal sacrospinous fixation usually results in good anatomic restoration. Uterosacral-cardinal ligaments attached to the vaginal membrane. Anatomic aspects of vaginal eversion after hysterectomy.
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The cul-de-sac is obliterated. There is no need to incorporate the round ligaments to the cuff, because they do not aid in cuff suspension and, in fact, may draw the ovaries to a position overlying the vaginal apex, predisposing the patient to dyspareunia. Before the 20th century, most treatments were partial or had serious drawbacks.
Halban cul-de-sac closure abdominal, uterus removed. Transvaginal double purse-string closure. Moreover, in some patients, preoperative presentation will differ; however, after vault support and plastic vaginal repair procedures have been performed, the vaginal vault still may be pulled to or past the hymen.