PROLAPS UTERI
Procedure
1. Transvaginal hysterectomy,
Colporaphy Anterior,
Colporaphy Posterior
Adit (T3B)/
Rachmad(T3A)/Dr. dr.
Hasanuddin, OBGYN ( C )
Case Outcome
Mrs. FA , 63 y.o, P3A0 1. Patient was in the lithotomy position under spinal
CM 1-16-24-78 analgesia
2. Asepsis and antisepsis of the surgical field
Diagnose Pre op : 3. Reevaluation under anaesthesia, it was grade III uterine
uterine prolapse prolapse grade III cystocele grade I rectocele.
grade III, Cystocele 4. Portio was clamped with tenacula
grade II 5. The vagina wall margin was identified.
6. Ellipse incision was performed at vagina wall ±2 cm from
Diagnose Post op: uretra
uterine prolapse 7. Anterior and posterior vaginal mucous was freed bluntly.
grade III, Cystocele 8. The bladder was pushed up, vesicouterine fold was
grade III, rectocle identified. The peritoneum was incised and opened.
grade II 9. The Douglas pouch was identified.
10. Right and left cardinal and sacrouterine ligament were
clamped, cut and sutured.
11. Bilateral uterine vessels were clamped, cut and sutured
12. Bilateral proximal tube, and ovarian ligament were
clamped, cut and sutured.
13. The uterus then was pulled out.
14. There was no bleeding on the pedicles, reperitonealization
was performed with PGA no 1
15. Performed colporapphy anterior
16. Performed colporapphy posterior
17. Foley catheter was inserted and urine production was
observed.
18. Estimated blood loss was 100 cc, clear urine 100 cc.
Now patient was in good condition and plan for discharged
waiting for PA result
 CRANIAL

CAUDAL

1. Ellipse incision was performed at vagina wall ±2 cm from uretra

2. Anterior and posterior vaginal mucous was freed bluntly.
3. The bladder was pushed up, vesicouterine fold was identified. The peritoneum was incised and opened.
4. The Douglas pouch was identified.
5. Right and left cardinal and sacrouterine ligament were clamped, cut and sutured.
6. Bilateral uterine vessels were clamped, cut and sutured
7. Bilateral proximal tube, and ovarian ligament were clamped, cut and sutured.
 CRANIAL

CAUDAL

8. The uterus then was pulled out.

9. There was no bleeding on the pedicles, reperitonealization was performed with PGA no 1
10. Performed colporapphy anterior
11. Performed colporapphy posterior
12. Foley catheter was inserted and urine production was observed.
Before TVH After TVH