SURGICAL CL/USL REPAIR USING VERTICAL INCISIONS
VIDEO repair CL/USL with vertical vaginal incisions using No2 polyester
sutures.
Vertical incisions are more familiar for those familiar with the
traditional Manchester operation. The surgical methodology as regards
dissection and ligament repair is identical to that for transverse
incisions. The vertical CL operation repairs a high cystocele
(transverse defect) and reconstructs the CLs of the prolapsed uterus
exactly as does the transverse incision. The cervix is grasped with a
tenaculum. A full thickness vertical incision is made from cervix to 1cm
short of the bladder neck. The bladder is dissected off the vagina and
cervix. CLs are identified and approximated with No2 polyester sutures.
A central defect is higher up, just below bladder neck, fig6. excess
vaginal tissue is not excised, but repaired by the vaginal conservation
technique, fig 7.