UROGYNECOLOGICAL SURGERY CURRENT APPROACHES AND TREATMENTS FOR INCONTINENCE

Urogynecological_Surgery_Kapak

CULDOPLASTY: CURRENT APPROACHES AND SURGICAL TECHNIQUES

Cihan Bademkıran

University of Health Sciences, Gazi Yaşargil Training and Research Hospital, Department of Gynecology and Obstetrics, Diyarbakır, Türkiye

Bademkıran C. Culdoplasty: Current Approaches and Surgical Techniques. In: Balsak D, Çim N, Ege S editors. Urogynecological Surgery Current Approaches and Treatments for Incontinence. 1st ed. Ankara: Türkiye Klinikleri; 2025. p.269-275.

ABSTRACT

Culdoplasty is an essential surgical approach in the management of pelvic organ prolapse (POP), designed to restore anatomical integrity by supporting the vaginal vault and reconstructing the posterior compartment. The technique has evolved significantly over time, ranging from conventional open surgery to advanced minimally invasive approaches. Among these, McCall culdoplasty stands out as a widely practiced and highly effective procedure for preventing vaginal vault prolapse following hysterectomy. By providing additional apical support, this technique has been shown to reduce recurrence rates and improve long-term quality of life. Recent developments in laparoscopic and robotic surgery have expanded the applicability of culdoplasty, offering improved visualization, reduced intraoperative complications, and enhanced cosmetic outcomes. V-NOTES (Vaginal Natural Orifice Transluminal Endoscopic Surgery) represents the latest innovation, enabling scarless surgery with faster recovery, although it requires a longer learning curve and specialized equipment. Evidence from recent clinical studies confirms the effectiveness of these approaches, reporting high levels of patient satisfaction and low complication rates. Furthermore, the integration of robotic systems has enhanced surgical precision and reduced morbidity, making culdoplasty a safer and more reliable option even in complex cases. Current literature emphasizes that careful patient selection and surgeon experience are critical for optimizing outcomes. In addition to its preventive role against vaginal vault prolapse, culdoplasty also contributes to reducing the risk of enterocele formation and other long-term complications. Overall, the procedure demonstrates strong safety and efficacy profiles across different surgical modalities, positioning it as a cornerstone in the surgical management of POP. Minimally invasive surgical methods will be more supported in the future.

Keywords: Culdoplasty; McCall; Pelvic organ prolapse; Laparoscopic surgery; Robotic surgery

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