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 intratoperative 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. (C) 2006 AAGL. All rights reserved.