Three categories of interventions can be identified (a) interventions on uterine arteries such as laparoscopic uterine artery ligation, uterine artery embolization, pericervical
mechanical tourniquet for uterine arteries and hormonal tourniquets such as vasopressin; (b) uterotonics such as ergometrine, oxytocin, misoprostol and sulprostone and (c) myoma dissection techniques which include the use of laser, electrosurgery and chemical dissectors such as sodium-2-mercaptoethanesulfonate (Mesna) (5-10).
After reading through this excerpt of the Master Class in Gynecologic Surgery, with the author's firm understanding of anatomy--especially the anatomic concerns associated with bladder prolapse--I believe the repair of the transverse defect caused by the separation of the pubocervical fascia from the pericervical
ring championed by Dr.
6), (8) Proximally, the septum fuses with the uterosacral ligaments laterally and the pericervical
The cured molds were then rinsed with the ethanol solution to remove any dirt that may have adhered to the molding material, especially around the pericervical
In the meantime, the entire cervix - with the uterus - is removed through the pericervical
ring by bikini cut.
Its proximal posterior edge is attached to the pericervical
To lower the risk of posthysterectomy prolapse, I include in my angle sutures the uterosacral ligament, vaginal mucosa, and anterior pericervical
The new transverse defect repair technique involves reattaching the pubocervical fascia to the pericervical
ring to correct the transverse defect.
The uterus is mobilized using the pericervical
cup and a 5-mm blunt probe.
If disruptions of this axis around the pericervical
ring are corrected surgically, the mechanical function of suspension can be reestablished, said Dr.
He simply emphasized the reconstruction and proper placement of the pericervical
ring in his excellent article.
The cardinouterosacral ligament wraps around the cervix, forming the pericervical
ring, a very important structure.