Review article
Abdominal sacrohysteropexy in young women with uterovaginal prolapse: long-term follow-up

https://doi.org/10.1067/S0002-9378(03)00665-3Get rights and content

Abstract

Objective

The purpose of this study was to evaluate the long-term efficiency after abdominal sacrohysteropexy in women with uterovaginal prolapse.

Study design

We conducted a retrospective chart review at our tertiary referral urogynecology unit. Thirty women of childbearing age with uterovaginal prolapse who wanted uterine preservation underwent abdominal sacrohysteropexy between 1987 and 1999.

Results

The mean age of the women was 35.7 years (range, 29–43 years). All women were parous. Thirteen women had grade 2 uterovaginal prolapse, and 17 women had grade 3 prolapse. In all women, the Burch procedure and posterior colporrhaphy were performed at the same time. Intraoperative and postoperative complications occurred in 2 patients (6.6%) and 4 patients (13.3%), respectively. The mean objective and subjective follow-up periods were 44.5 months (range, 2–156 months) and 94.6 months (range, 8–160 months), respectively. At the time of the last physical examination, there were two cases of recurrent uterovaginal prolapse (6.6%), which was symptomatic in 1 patient and required repeat surgical treatment. At the time of the last questionnaire, apart from the patient who underwent repeat surgery, no patients had any uterovaginal prolapse symptoms. Three women had pregnancies that were conceived spontaneously, which led to three early legal abortions.

Conclusion

The abdominal sacrohysteropexy is effective and safe in the treatment of uterovaginal prolapse in women of childbearing age. This procedure has a high success rate in correcting prolapse without a time-dependent decrease in efficiency.

Section snippets

Material and methods

Between June 1987 and July 1999, 30 consecutive women of childbearing age with grade 2 (n = 13 women) or grade 3 (n = 17 women) uterovaginal prolapse who wanted uterine preservation were enrolled in the study. Before abdominal sacrohysteropexy, each patient was assessed by questionnaire, physical examination, and urodynamic study.

Subjective assessment was based on symptoms of uterovaginal prolapse that included pelvic pressure, bulging and a falling-out sensation, followed by constipation,

Results

The mean age of the 30 patients was 35.7 years (range, 29–43 years); the mean parity was 2.3 (range, 1–5), and the mean body mass index was 21.9 kg/m2 (range, 17.7–28 kg/m2). All patients were healthy and active. All patients wished to conserve the uterus because it was an integral part of themselves and to preserve their fertility. All patients had been delivered of at least one child. The other demographic characteristics of the patients who underwent abdominal sacrohysteropexy are shown in

Comment

The surgical treatment of uterovaginal prolapse in young women consists of correcting the prolapse with the most long-lasting results, which allows normal sexual function and preserves childbearing function. In young women, three main approaches have been advocated for the treatment of uterovaginal prolapse: a Manchester procedure, transvaginal sacrospinous fixation, or an abdominal suspension (by laparotomy or laparoscopy).

We report long-term efficiency in women of childbearing age with

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