Which Surgical Procedure Is Best for Uterine Prolapse?

A large randomized trial finds the efficacy of sacrospinous hysteropexy and vaginal hysterectomy comparable at 12 months.

More than one third of women over 45 experience uterine prolapse, which can impair physical, psychological, and sexual function. To compare uterine-preserving surgery with hysterectomy, investigators at four large Dutch teaching hospitals randomized 208 candidates for surgical treatment of uterine prolapse (median age, 62; range, 33-85) to sacrospinous hysteropexy or vaginal hysterectomy with uterosacral ligament suspension. The primary outcome was recurrent prolapse of the uterus or vaginal vault 1 cm above the hymen or beyond with bothersome bulge symptoms or repeat surgery for prolapse within 12 months.

Mean postoperative hospital stay was 3 days in both groups and occurrence of urinary retention was similar. At 12 months, no women in the…

Reviewing Author

Andrew M. Kaunitz, MD

Disclosures

RoyaltiesUpToDate

Grant/Research SupportMerck, Mithra, Medicines360

Editorial BoardsContraception; Menopause; Contraceptive Technology Update; OBG Management; Medscape OB/GYN & Women’s Health

Andrew M. Kaunitz, MD

Disclosures

RoyaltiesUpToDate

Grant/Research SupportMerck, Mithra, Medicines360

Editorial BoardsContraception; Menopause; Contraceptive Technology Update; OBG Management; Medscape OB/GYN & Women’s Health

Which Surgical Procedure Is Best for Uterine Prolapse?

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Reviewing Author