Abdominal sacral hysteropexy: a pilot study comparing sacral hysteropexy to sacral colpopexy with hysterectomy.

OBJECTIVES: Treatment of pelvic prolapse with uterine conservation using the sacral hysteropexy may be associated with less patient morbidity but has uncertain subjective and objective outcomes. We sought to compare abdominal sacral hysteropexy (ASH) with sacral colpopexy/total abdominal hysterectomy (ASC/TAH).

METHODS: This is an ambispective (retrospective/prospective) cohort pilot study comparing ASH to ASC/TAH. The primary outcome was global impression of improvement. Secondary outcomes were based on validated quality-of-life questionnaires and surgical complications.

RESULTS: Eighteen ASHs were compared to 9 ASC/TAHs after a mean follow-up of 19 months. Whereas subjective outcomes did not differ, anterior failure (55%) and subsequent uterine pathology (22%) were higher in the ASH cohort. Graft erosion occurred in 33% of the ASC/TAH group.

CONCLUSIONS: The ASH offers advantages and disadvantages that warrant further investigation with a prospective study.