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High Midline Levator Myorrhaphy for Vault Prolapse Repair

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Native Tissue Repair for Incontinence and Prolapse

Abstract

High midline levator myorrhaphy (HMLM), first described in 1988, is a vaginal surgery for vault prolapse (VP) that does not rely on mesh interposition, avoids the inherent difficulties associated with sacrospinous ligament fixation (SSLF) involving nearby vascular and neural structures, and is well-suited for middle-aged to older women [1]. Unlike the SSLF [2, 3], HMLM keeps the vagina midline, and unlike the uterosacral ligament (USL) fixation [4], HMLM can be done many years after hysterectomy when the uterosacral ligaments are no longer readily identifiable. Since its original report, there have been few published series on surgical outcomes [1, 5], none of which included long-term data. We review the technique of this procedure in detail and provide an update on our long-term experience with this technique.

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References

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Correspondence to Philippe E. Zimmern .

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Wu, Y.(., Zimmern, P.E. (2017). High Midline Levator Myorrhaphy for Vault Prolapse Repair. In: Zimmern, P., De, E. (eds) Native Tissue Repair for Incontinence and Prolapse. Springer, Cham. https://doi.org/10.1007/978-3-319-45268-5_11

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  • DOI: https://doi.org/10.1007/978-3-319-45268-5_11

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-45266-1

  • Online ISBN: 978-3-319-45268-5

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