Laparoscopic uterosacral uterine suspension: a minimally invasive technique for treating pelvic organ prolapse.

STUDY OBJECTIVE: To assess the surgical outcomes of laparoscopic uterosacral uterine suspension and describe the surgical technique.

DESIGN: Retrospective chart review (Canadian Task Force classification II-3).

SETTING: University tertiary medical center.

PATIENTS: Twenty-three patients with symptomatic uterine prolapse and desire for uterine preservation who underwent surgical repair.

INTERVENTION: Laparoscopic uterine uterosacral uterine suspension.

MEASUREMENTS: Preoperative and postoperative evaluations were completed. The stage of pelvic organ prolapse was assessed using the ICS pelvic organ prolapse quantification (POP-Q) examination. Descriptive statistics and paired t testing were used for statistical analysis.

RESULTS: Nineteen of 23 patients (82.6%) had preoperative prolapse stage 2 or greater. Nine patients (40.9%) had uterine prolapse beyond the hymen. After operation there were significant improvements in the stage of prolapse (2 vs 0, p<.01). The POP-Q scores for point C and D were significantly further away from the hymen after operation than compared with the preoperative values (-0.6 vs -7.8, and -5.0 vs -8.6; p<.01) respectively. There were no intraoperative complications. The estimated blood loss (mean+/-SD) was 111.5+/-139.4 mL. The hospital stay (mean+/-SD) was 2.2+/-1.7 days. None of the patients had symptomatic prolapse during the mean follow-up of 15.9 months.

CONCLUSION: Laparoscopic uterine suspension appears to be a safe and effective treatment option for uterine prolapse in patients who desire uterine preservation.