At approximately 13 weeks, these two solid evaginations grow out of the pelvic part of the urogenital sinus and proliferate into the caudal end of the uterovaginal canal to become a solid vaginal plate.
Suspension of the vagina to the presacral region is an effective treatment for uterovaginal prolapse. The abdominal approach was considered if the patient had uterine or ovarian pathology that needs to manage with hysterectomy or adnexectomy and also have anterior vaginal defect or urinary incontinence that needs to perform paravaginal defect repair or Burch colposuspension. Total recurrence rate was 13.7% with transvaginal approach. Moreover, the recurrence rate was 5% by abdominal approach. About 92% of success rate by the robotic surgery that there was no significant difference with vaginal approach. Robotic surgery could be done with uterosacral suspension concomitant total or subtotal hysterectomy.
Patients were excluded from the study if they had undergone previous cervical cone biopsy or surgery requiring cervical tissue removal; cervical incompetence; a history of cervical laceration repair during vaginal birth; cervical stenosis; contraindications for the use of misoprostol (history of severe asthma, glaucoma, pre-existing cardiac disease, hypertension, or renal failure); or significant uterovaginal prolapse precluding the administration of vaginal tablets.