Cytoscopic light test to aid in the differentiation of high-grade pelvic organ prolapse

Laparoscopic repair of inguinal cystocele using cystoscopic light test

OBJECTIVE

To describe how the cystoscopic light test aids in the repair of inguinal bladder herniation.

METHODS

After the diagnosis of a bladder herniation into the right inguinal canal using intravenous pyelography, laparoscopic repair was planned. A cystoscope was manipulated into the defect while turning off the laparoscopic light intra-abdominally. The light of the cystoscope could be identified through the cystocele, and the neck of the hernia was easily recognized. Once the bladder was reduced, the cystoscope was replaced, and reduction of the herniation was confirmed.

RESULTS

We were able to successfully reduce the bladder herniation without recurrence at 24 months of follow-up.

CONCLUSION

The cystoscopic light test represents a useful tool in the recognition of an inguinal bladder herniation, before, during, and after the definitive repair of the defect.

An update on surgery for pelvic organ prolapse

PURPOSE OF REVIEW

The surgical management of pelvic organ prolapse continues to evolve. Recent advancements in techniques and materials have increased the available treatments for pelvic organ prolapse. A current understanding of the benefits and limitations offered by recently introduced materials and techniques is essential to their proper application.

RECENT FINDINGS

Current surgical therapies for prolapse now include augmentation with synthetic mesh, which may also be utilized as part of a 'kit'. In addition, both laparoscopic and robot-assisted techniques have been developed to address apical vaginal prolapse. Both the use of synthetic mesh and laparoscopic and robotic techniques should continue to be subjected to appropriate scrutiny to assess their long-term success and complications.

SUMMARY

While the introduction of novel approaches to pelvic organ prolapse provide further options when considering appropriate therapy, the application of these materials and techniques should be examined with scientific rigor and should demonstrate both a significant benefit and low morbidity prior to widespread adoption. With continued research, we hopefully will be able to identify the ideal approaches and repairs to achieve optimal patient outcomes.