Transvaginal Cystocele and Rectocele Repair, Using a New Very Simple Suturing DE-ALWIS TECHNIQUE

Abstract

The purpose of this exercise is to introduce a very simple new technique of epithelial closure, in this case the vaginal wall. The new technique (the de Alwis method) has been used by us for decades. Proplapse of the uterus or several pelvic organs has been a problem for centuries and a most embarrassing experience for many. Different surgical and nonsurgical measures have been performed over centuries. The de Alwis method of vaginal epithelial wall approximation is shown to be cosmetically most accepted in our unit and has had no adhesions nor granulation tissue formation. Purpose: A different technique of vaginal repair with the de Alwis suturing technique of epithelium approximation, over a twenty-year period. Method: This is a retrospective review of 41 patients who underwent vaginal repairs with the de Alwis method suturing technique, for over a decade. In many, the Baden-Walker halfway classification was used before and during follow-up. Four elderly frail patients, with vaginal vault prolapsed and who were not sexually active, opted for Le Forts’ colpocleisis. Transvaginal vaginal repair followed by vaginal epithelial closure using the de Alwis surgical technique, had no granulation tissue formation, and was cosmetically satisfying.