Volume 51, Issue 4, Pages 1065-1072 (April 2007) Midterm Follow-up of High-Grade Genital Prolapse Repair by the Trans-obturator and Infracoccygeal Hammock Procedure after Hysterectomy  Loïc Sentilhes, Fabrice Sergent, Benoît Resch, Eric Verspyck, Philippe Descamps, Loïc Marpeau  European Urology  Volume 51, Issue 4, Pages 1065-1072 (April 2007) DOI: 10.1016/j.eururo.2006.11.022 Copyright © 2006 European Association of Urology Terms and Conditions

Fig. 1 View of the mesh. The two arms of the T-shaped part are placed tension-free through the obturator space; the foot is placed in the rectovaginal wall. The 8-mm tape perforates the levator ani muscles and is used as a tie on the base of the T mesh where it was fixed. 1=bladder; 2=vagina; 3=rectum; 4=iliococcygeus part of levator ani muscle. European Urology 2007 51, 1065-1072DOI: (10.1016/j.eururo.2006.11.022) Copyright © 2006 European Association of Urology Terms and Conditions

Fig. 2 The T-shaped part with the 8-mm tape. European Urology 2007 51, 1065-1072DOI: (10.1016/j.eururo.2006.11.022) Copyright © 2006 European Association of Urology Terms and Conditions

Fig. 3 (a) Placement of the left arm in tension-free (black arrow) then (b) of the right arm (black arrow) of the T mesh through the left obturator space. (c) Insertion of the left extremity of the 8-mm prosthetic tape was via the left ischiorectal fossa to perforate the levator muscles by the left perineal skin incision (black arrow), as described by Petros [15]. It was used as a tie on the base of the T mesh (white arrow). (d) Repetition of the procedure on the contralateral side. The foot of the T mesh will be then placed in the rectovaginal wall. The anterior and posterior vaginal wall will then be closed and the trans-obturator and infracoccygeal extensions of each side will be tied. European Urology 2007 51, 1065-1072DOI: (10.1016/j.eururo.2006.11.022) Copyright © 2006 European Association of Urology Terms and Conditions