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I fully agree with the suggestion that the issue is point D. I have been using Point D for many years and was bolstered by the data that came out and supported this concept. If point D is higher than -5 when the patient is standing then I do a TVH, vaginal ...
Definitely wait until she finishes breast feeding and allow vaginal tissues to return to their estrogenized state. While SSL Fx is an excellent procedure and I have performed thousands of them (and still perform them), unless this patient is ...
Iglesias showed that the decision point is D. If worse than-5 then failure rate is higher with vaginal surgery. I like-6 and a traditional McCall or high uterosacral will give good results D is a measure of evidence of inherent uterosacral support ...