Laparoscopic Vaginosaceopexy Cervicosacropexy ( Cesa Vasa) Surgery

Laparoscopic Vaginosaceopexy Cervicosacropexy ( Cesa Vasa) Surgery

Urinary incontinence (Involuntary Urination):

Female Urinary incontinence and pelvic organ prolapse using the latest innovative technology in Turkey and European countries.

Laparoscopic Bilateral Cervicosacropexy and Vaginosacropexy, new surgical treatment option in women with pelvic organ prolapse and urinary incontinence

There are two types of urinary incontinence in women. One is the type that we call stress incontinence during coughing and sneezing, and other is the incontinence before reaching the toilet (urgent incontinence, overactive bladder). In some women, the two are seen together (mixed incontinence). The classic approach is surgery for incontinence and non-surgical treatments for overactive bladder (OAB). In the mixed type, the treatment is selected according to the patient’s complaints.

Overactive bladder occurs in more than half of postmenopausal women. This is manifested in frequent urination and an urgent need to urinate- incontinence and urination at night. So far it is known that the treatment of overactive bladder is non-surgical (Gynecology and drugs-04, physiotherapy, magnetic chair, Botox, ect.). The definitive treatment with these methods is very difficult and the disease recurs when treatment is stopped. The purpose of these treatments is to improve the patient’s quality of life.

Overactive bladder is observed in more than half of postmenopausal women, which are:

• Frequent urination
• Urination to urinate
• Urine leakage
• Urinating at night

Treatment of urinary incontinence (involuntary urination) by the latest surgical methods CESA and VASA

This technique restores the structure of the ligaments with a new mesh (surgical set) in patients with overactive bladder. Where the surgery was performed for the first time as an open surgery, but now it is done by a closed operation (Laparoscopic). The operation is performed on two groups of patients using different methods. If the patient’s uterus was transferred previously, the mesh is installed in the upper part of the uterus, passed through the ligaments of the uterus (sacral ligaments) and installed on both sides of the sacral bone. This process is known as Vasovasostomy.

If the patient’s uterus is still present and if her age is appropriate, the uterus is removed by preserving the cervix (sub-hysterectomy) and the mesh is installed on the cervix.

If the patient suffers from mixed urinary incontinence, and urine leakage during coughing and sneezing, a TOT procedure (Transobturator strip) is performed for this purpose, and thus, the pelvic floor acquires its normal anatomy.

A swing is created extending from the pubic bone to the sacrum, and the vaginal vault remains on this swing, which are the anatomical locations of the bladder. One of the most important advantages of this surgery is that in the case of anal prolapse and rectal prolapse (the last part of the large intestine) can be treated at the same time. The straightener is fixed to the mesh arms on both sides. And therefore, the prolapse of this area is also corrected. Rectal prolapse is a difficult condition to treat, and sometimes it coexists with genital prolapse. There is no need for an additional operation for rectal prolapse for those who undergo this operation.

This method is considered one of the new methods, as a cornerstone in the treatment of overactive bladder, which will be very beneficial for our patients.

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