PHVP

Option List:
A. No treatment
B. Open abdominal sacrocolpopexy (ASC)
C. High uterosacral ligament suspension (HUSLS)
D. Robotic sacrocolpopexy (RSC)
E. Transvaginal mesh (TVM)
F. Colpocleisis
G. Vaginal pessaries
H. Pelvic floor muscle training
I. Sacrospinous fixation (SSF)
J. Subtotal hysterectomy

1. A 65-year-old patient undergoes vaginal hysterectomy. The vault descends to the introitus during closure. Which procedure, if any, is appropriate to prevent PHVP

2. A 70-year-old patient has a grade I PHVP. She is active, generally well and her only regular medication is Ramipril 2.5mg.

3. A 66-year-old patient with symptomatic PHVP has consented to surgery. She has short vaginal length and is sexually active.