Uterine Prolapse-Need for Hysterectomy?

Kim, Joo Myung; Cho, Jun Hyung; Kim, Tae Jin; Joo, Kwan Young

Abstract

OBJECTIVE
To compare the efficacy of transvaginal sacrospinous colpopexy with hysterectomy and without hysterectomy for symptomtic uterine prolapse when performed by one surgeon.
METHODS
Between march 1996 and march 2002, 59 women with a symptomatic uterine prolapse were treated with either transvaginal sacrospinous ligament colpopexy with hysterectomy (30 cases=Group A) or transvaginal sacrospinous cervicocolpopexy without hysterectomy (29 cases=Group B). Patients were reviewed at least 12 months after operation.
RESULTS
The mean age, parity, prolapse grade, menopausal status, body weight and length of follow-up for two groups were no difference. There were two intraoperative complications-Rectal wall injury one patient in group A and one in group B. The mean duration of surgery, hemoglobin change, inpatient days and catheter days were shorter in group B compared with group A. Recurrent asymptomatic cystocele developed in 2 patients in group A and 2 in group B. One patient in group A and one patient in group B required repeat operation for recurrent pelvic organ prolapse. There was no significant difference between the two groups in postoperative satisfactory result (96.7% vs 98.6%, respectively p=0.51).
CONCLUSION
Sacrospinous cervicocolpopexy without hysterectomy and sacrospinous colpopexy with hysterectomy are equally effective surgical operation for uterine prolapse. Sacrospinous cervicocolpopexy without hysterectomy avoids the potential morbidity of vaginal hysterectomy and decreases the operation time, blood loss, inpatient days and catheter days. Vaginal hysterectomy may not be necessary in the correction of uterine prolapse.