In this brief overview, conventional and endoscopic surgery is reported, related to the specific site of the prolapse. The technique which was modified by Tanagho implies an elevation of the bladderneck to bring it back in the abdominal pressure zone. To achieve this the paravaginal fascia is suspended with two sutures to Coopers ligament on each side. Although the results are promising, the long-term effectivity is questioned. Technical problems of laparoscopic suturing may play an important role, as the short-term results of stapling a mesh between vagina and Coopers ligament seem to be better.
Patients undergo the operation under light sedation and are discharged the same day.
This operation is frequently performed in combination with a hysterectomy in case of uterine prolapse. Especially if urinary incontinence exists and bladder surgery is indicated, the abdominal approach with paravaginal repair and colposuspension is preferable. By gynecologists who have mastered laparoscopic suturing, this operation can be done laparoscopically. In the past the paravaginal repair fell into disuse because the arcus tendineus was recognized as a weak repair site. This technique was first described by Lane.