Pelvic ligament suspension surgery

Why ligaments, and what the surgery does

Pelvic ligament suspension surgery was developed by Dr. Mo Hyung-jin, the clinic's medical director. A patent application for the technique has been filed with the Korean Intellectual Property Office. The related surgical methods are registered trademarks: MLR, WLR, SVR and LSL. The technique restores pelvic support by re-anchoring the patient's own lax pelvic ligaments. It is used for stress urinary incontinence, cystocele, rectocele and uterine prolapse.

The pelvic organs are held in place by a hammock of muscle and by connective-tissue ligaments. Anatomists describe three levels of support: at the highest level, the uterosacral and cardinal ligaments hold the cervix and upper vagina; in the middle, lateral attachments hold the vaginal walls beneath the bladder and in front of the rectum; at the lowest level, the perineal body and its muscles close the outlet. Childbirth, ageing, oestrogen loss and chronic straining stretch these ligaments. When they lengthen, the bladder neck drops (stress incontinence), the front wall bulges (cystocele), the back wall bulges (rectocele) or the uterus descends (uterine prolapse).

Many operations treat the visible result: a sling is placed under the urethra, or the stretched vaginal wall is folded and stitched. Pelvic ligament suspension is directed at the ligaments themselves. The lax supports are shortened and re-anchored so that the organ is held from above again, using the patient's own tissue.

Because the same principle applies to several conditions, one operation can often address more than one problem when they occur together. Whether that is the case for you is decided at consultation, after examination and measurement.

The six steps

1. 01 Consultation and measurement
   Pelvic examination, vaginal endoscopy imaging, ultrasound and, where relevant, measurement of vaginal laxity. We tell you which level of support has failed and what we propose.
2. 02 Pre-operative check-up
   Blood and urine tests and a review of your medications and past surgery.
3. 03 Anesthesia
   Planned for the procedure and for you under the clinic's four-step protocol.
4. 04 Surgery
   Performed in the clinic's operating room. Operating time depends on how many areas are repaired.
5. 05 Recovery suite
   In a private single-occupancy recovery suite, with an overnight stay where your plan includes one.
6. 06 Check-up, documents, follow-up
   A check-up before you travel, discharge instructions in English, insurance documents, and a 24-hour nurse line.

Anesthesia follows a four-step protocol tailored to the procedure and the patient. Anesthesia is planned per patient. Tell us about previous anesthesia experiences and current medications during pre-consultation.

For international patients

Consultations are available in English. We prepare the documents international insurers typically require: an itemized English receipt, a medical certificate, procedure codes and a completed claim form. Send us your history and any operative notes from earlier surgery and we will reply with a written plan. Your written plan gives the number of days to allow in Seoul. It usually covers consultation and tests, the operation, one night in the clinic and a check-up before you fly.