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|Type:||Artigo de periódico|
|Title:||The Simplified Vaginal Wall Sling|
Netto Jr. N.R.
|Abstract:||This video shows the anatomical and functional grounds of the modified Raz vaginal wall sling. The procedure is performed under spinal anesthesia with the patient in the lithotomy position. Saline infiltration of the anterior vaginal wall facilitates dissection. Two oblique incision are made, the apex of which is located proximal to the urethral meatus and the base of which is extended several centimeters proximal to the bladder neck. Sharp and blunt dissection are used to enter the retropubic space on both sides. Helical sutures are placed at the level of the bladder neck and mild urethra. The sutures at the level of the bladder neck incorporate the vaginal wall excluding the epithelium, pubocervical fascia and urethropelvic ligaments. The sutures at the mild urethra incorporate the vaginal wall whithout the epithelium urethropelvic ligament and levator musculature at 3 and 9 o'clock positions. A small 1 cm skin puncture is mad just superior to the pubic symphysis and is extended down to the fascia. A double pronged needle is used to individually transfer the propilpropilene sutures previously made, from the vagina to the suprapubic region. Minimal tension is placed on the suspension sutures. Cystoscopy is performed to rule out lower urinary tract lesions. Incisions are closed in thp usual manner and a Foley catheter is left place for 2 days. This technique allows for the correction of anatomic urinary stress incontinence as well as intrinsic sphincteric deficiency.|
|Appears in Collections:||Unicamp - Artigos e Outros Documentos|
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