Surgical Management of Pelvic Organ Prolapse Might Not Require Removing the Uterus

A uterine sparing technique, sacrospinous hysteropexy, was associated with low likelihood of recurrent symptoms or prolapse.

To test the long-standing thesis that successful surgical treatment of women with pelvic organ prolapse (POP) requires uterine removal, investigators randomized 204 women with POP (mean age, 62) to vaginal hysterectomy (VH) or a uterine sparing technique, sacrospinous hysteropexy (SH). In the VH group, the apex of the vagina was attached to the uterosacral ligaments with sutures; in the SH group, the posterior side of the cervix was attached to the right sacrospinous ligament. In both groups, repair of vaginal wall defects was performed if indicated.

At 5 years' follow-up, a composite measure of surgical success (no prolapse of vaginal tissue beyond the hymen, absence of bulge symptoms, and no repeat surgery or pessary use) occurred in 76% a…

Reviewing Author

Robert L. Barbieri, MD

Disclosures

Grant/Research SupportNational Institutes of Health

Editorial BoardsUpToDate

Robert L. Barbieri, MD

Disclosures

Grant/Research SupportNational Institutes of Health

Editorial BoardsUpToDate

Surgical Management of Pelvic Organ Prolapse Might Not Require Removing the Uterus

Topics

Reviewing Author