Abstract
Both General and Oncologic Gynecologists are called upon to address prolapse issues during hysterectomy for benign or malignant indications. The technique for Uterosacral Ligament (USL) Colposuspension is best begun by placement of permanent sutures 3 cm from the cervix, through each of the USL's, while tented up by the intact uterus, after visualizing the ureters. Then, after the hysterectomy and vaginal closure are complete, these sutures are tensed, delineating the more distal USL for permanent suture placement 1.5 cm from the cervix, which is then passed through the posterior and then anterior pubocervical fascia on each side and tied. Finally, the original sutures placed 3 cm from the cervix are passed through the more medial posterior and anterior vaginal fascia, and tied, lifting the vaginal apex. Cystoscopy is then performed to confirm ureteral patency.
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