Combined laparoscopic uterosacral and round ligament procedures for treatment of symptomatic uterine retroversion and mild uterine decensus

摘要

Study Objective. To evaluate the efficacy of a new modified technique to treat a symptomatic retrodisplaced uterus. Design. Prospective clinical study (Canadian Task Force classification 11-2). Setting. Tertiary care university hospital. Patients. Thirty-one women with symptomatic uterine retrodisplacement but without significant pelvic pathology. Intervention. Laparoscopic shortening and plication of uterosacral ligaments with modified Gilliam suspension. Measurements and Main Results. In average follow-up of 3.3 ?1.0 years, all patients had an anteverted, anteflexed uterus. Mean ?SD operating time was 24.1 ?4.7 minutes. There were no complications during or after surgery, Dyspareunia scores before and after surgery were 5.4 ?1.4 and 0.5 ?0.7, respectively (p <0.001). Chronic pelvic pain was satisfactorily relieved in seven of nine women. Vagina lengths before and after surgery were 5.9 ?0.7 and 7.0 ?0.3 cm, respectively (p <0.001). Conclusion. Our technique achieved long-lasting good results in suspending uteri in anteverted, anteflexed position and relieved symptoms caused by retrodisplacement.