Genç bir hastada total uterin prolapsus tedavisinde Carter-Thomason operasyonu: olgu sunumu

Uterin prolapsus, kadın popülasyonunda oldukça yaygın bir problem olup kesin tedavisi cerrahidir. Vajinal histerektomi, prolapsus için en sık kullanılan yöntem olmakla beraber genç hastalarda uterin koruyucu cerrahi ön planda düşünülmelidir. Carter-Thomason operasyonu, round ligamentlerin laparoskopik olarak suspanse edildiği uterus koruyucu cerrahi bir yöntemdir. Özellikle fertilite arzusu olan genç kadınlarda uterin prolapsus tedavisinde kullanılabilmektedir. Akut, redükte edilemeyen uterin prolapsus mevcudiyeti nedeniyle başvuran 30 yaşındaki bir kadına, anestezi altında redüksiyon sonrası modifiye Carter-Thomason metodu kullanılarak laparoskopik uterin suspansiyon işlemi yapıldı. Bu olguyu son literatür bilgileri ışığında tartışmayı amaçladık.

Carter-Thomason operation in the treatment of uterin prolapsus in a young patient: case report

Uterine prolapsus is a common problem which absolute treatment is surgery. Although vaginal hysterectomy is the most used method in the treatment of the prolapsus, uterine protective surgery should be thought primarily. Carter-Thomason method is a uterine protective surgery which round ligaments are suspansied by laparoscopically. Especially it can be used in the uterine prolapsus treatment in young women who has desire for fertility. Laparoscopic uterine suspension technique which named Modify Carter Thomason method were carried out under general anesthesia after the reduction to a thirty year old female patient who applied to our clinic with acute, non-reductable uterine prolapsus complaint. We aimed to discuss this case in the light of recent literature.

PDF

___

1. Olsen AL, Smith VJ, Bergstrom JO, Colling JC, Clark AL. Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence. Obstet Gynecol 1997;89:5016.
2. Lin LL, Ho MH, Haessler AL, Betson LH, Alinsod RM, Liu CY et al. A review of laparoscopic uterine suspension procedures for uterine preservation. Curr Opin Obstet Gynecol 2005:17:54146.
3. OBrien PM, Ibralim J Failure of laparoscopic uterine suspension to provide a lasting cure for uterovaginal prolapse. Br J Obstet Gynaecol 1994;101:7078.
4. Krause HG, Goh JT, SLoane K, Higgs P, Carey MP. Laparoscopic sacral suture hysteropexy for uterine prolapse. Int Urogynecol J Pelvic Floor Dysfunct 2006; 17: 378-81.
5. Barranger E, Fritel X, Pigne A. Abdominal sacrohysteropexy in young women with uterovaginal prolapse: Long-term follow-up. Am J Obst Gynecol 2003; 189:1245-50.
6. Cutner A, Kearney R, Vashisht A. Laparoscopic uterine sling suspension: a new technique of uterine suspension in women desiring surgical management of uterine prolapse with uterine conservation BJOG 2007:114;115962.
7. Lowenstein L, Dooley Y, Kenton K, Mueller E, Brubaker L. Neural pain after uterosacral ligament vaginal suspension. Int Urogynecol J Pelvic Floor Dysfunct 2007;18:10910.
8. Maher CF, Cary MP, Slack MC, Murray CJ, Milligan M, Schluter P. Uterine preservation or hysterectomy at sacrospinous colpopexy for uterovaginal prolapse? Int Urogynecol J Pelvic Floor Dysfunct 2001;12:3814.
9. Price N, Slack A, Jackson SR. Laparoscopic hysteropexy: the initial results of a uterine suspension procedure for uterovaginal prolapse. BJOG. 2010; 117(1):62-8.
10. Wu MP. Laparoscopic uterine suspension for the treatment of uterovaginal prolapse. Int J Gynaecol Obstet 1997;59:25960.