Hysteropexy: an Option for the Repair of Pelvic Organ Prolapse

Current Urology Reports
Sarah BradleyLee A Richter

Abstract

Women have an estimated 12.6% lifetime risk of undergoing surgery for pelvic organ prolapse in the USA (Wu et al. in Obstet Gynecol 123(6): 1201-6, 2014). Surgical repair of uterovaginal prolapse most commonly includes hysterectomy and vaginal vault suspension; however, the value of concomitant hysterectomy is uncertain, and there appears to be growing interest in uterine conservation. Multiple procedures have evolved using a variety of approaches. The aim of this paper is to review uterine sparing (hysteropexy) prolapse repair techniques and outcomes. Several randomized controlled trials (RCT) have shown comparable success rates for apical compartment support with sacrospinous hysteropexy as compared to vaginal hysterectomy with uterosacral ligament suspension, with shorter hospitalization and quicker return to work. (Detollenaere et al. in BMJ 351: h3717, 2015); (Dietz et al. in Int Urogynecol J Pelvic Floor Dysfunct 21(2): 209-16, 2010). Available data suggest vaginal mesh hysteropexy is as effective as vaginal mesh with hysterectomy, with lower rates of mesh exposure. (Maher et al., 2017) To date, no RCTs have been published comparing sacral hysteropexy to hysterectomy with sacral colpopexy. Overall, there is a higher reope...Continue Reading

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Citations

Jan 14, 2021·International Urogynecology Journal·Andre PlairCatherine Matthews
Aug 6, 2019·European Journal of Obstetrics, Gynecology, and Reproductive Biology·Ruby MartinelloPantaleo Greco
Feb 24, 2021·Female Pelvic Medicine & Reconstructive Surgery·Rebecca KurianGary Sutkin

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