Uterus-sparing Surgery - Outcomes of Transvaginal Uterosacral Ligament Hysteropexy.

Abstract Study Objective Recently, there has been a paradigm shift towards uterine conservation during the surgical management of pelvic organ prolapse (POP), specifically uterine prolapse. There are few reports on transvaginal uterosacral ligament hysteropexy (TULH). This study aimed to describe our surgical technique and outcomes. Design A retrospective review and description of surgical technique. Anatomical outcome is reported utilizing Pelvic Organ Prolapse Quantifications System (POP-Q). Complications were segregated. A comparison of parametric continuous variables was performed using paired student t test. Categorical variables were evaluated using Pearson's chi-squared test and Fisher's exact test. A p-value Setting A teaching hospital Patients Forty patients who underwent transvaginal uterosacral ligament hysteropexy from 2009-2017 Interventions Transvaginal uterosacral ligament hysteropexy Measurements and Main Results 40 patients met the inclusion criteria. 56.1% had preoperative stage 3 prolapse. The median operative time was 116 minutes. The mean estimated blood loss was 158.5 milliliters. Transient ureteral obstruction occurred in 2 patients. The mean follow-up time was 17.2 months and all patients had significant improvement of prolapse (p Conclusion Transvaginal uterosacral hysteropexy is an effective uterus-preserving surgical alternative for the treatment of uterovaginal prolapse, and provides good apical support. It is also associated with low short-term recurrence and incidence of reoperation. TULH is a viable option for suitable patients with uterovaginal prolapse who desire uterine conservation.