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One woman required a laparotomy for bleeding from the pre-sacral area. 21 In this series one recurrence of vault prolapse was reported in follow up ranging from 6 months to 2 years. Of interest was the finding of low rectocoeles in ten of the women when examined 6 months postoperatively, although the women were not always aware of the prolapse. In an attempt to reduce the incidence of recurrence of posterior vaginal wall prolapse the author performed a number of procedures in which prolene mesh was introduced vaginally during a conventional posterior repair thereby reinforcing the full length of the posterior vaginal wall.
Cancer surgery that will destroy fertility The scenario A 29–year-old nurse had an abnormal cervical smear and a cone biopsy had revealed a moderately differentiated squamous cancer, invading 2 mm below the basement membrane and with lymphatic involvement. The primary tumour was completely 25 03Ch3-cpp 14/11/01 2:15 pm Page 26 ADVANCES IN GYNAECOLOGICAL SURGERY excised and the pathologist reported a wide margin of normal tissue around the tumour. The nurse has no children. What treatment should she choose?
Am J Obstet Gynecol 1996; 175: 1418–22. 4. Vancaillie TG, Schuessler W. Laparoscopic bladder neck suspension. J Laparoendosc Surg 3: 169–73. 5. Liu CY. Laparoscopic retropubic colposuspension (Burch procedure). J Reprod Med 1993; 38: 526–530. 6. Lavin JM, Lewis CJ, Foote AJ, Hasker GL, Smith ARB. Laparascopic Burch Colposuspension Paper. Gynae Endoscopy 1998; 7: 251–258. 7. Burton G. A three year prospective randomised urodynamic study comparing open and laparoscopic colposuspension. Continence Foundation Australia.