• Farkhunda Khursheed
  • Chandra Madhu Das
  • Ambreen Ghouri


Background: The traditional surgical treatment of utero-vaginal prolapse is vaginal hysterectomy. In recent years, the procedure of sacral hysteronpexy is gaining popularity.  This study was conducted to determine the frequency of uterine prolapse in young women and to analyze the results of abdominal sacrohysteropexy. Methods: This descriptive case series was conducted in department of Gynaecology and obstetrics Unit-II, Liaquat University of Medical and Health Sciences form October 2008 to October 2011. All those women admitted during the study period with uterine prolapse and requiring uterine conservation surgery were included in the study. After evaluation and pre- operative assessment, abdominal sacrohysteropexy was performed. Results of surgery were analyzed in terms of duration of surgery, intra-operative and post-operative complications, need for blood transfusion during surgery and duration of hospital stay. After discharge they were followed for a period of 6 months. Results: A total of 210 cases of uterine prolapse were admitted during the study period. Out of these, abdominal sacrohysteropexy was performed in 33 cases (15.71%). In these 33 cases, 4 (12.12%) were unmarried and 29 (87.87%) were married. In 29 married women, 10 (34.48%) were nulli-para, 12 (41.37%) were para 1 or 2 and 7 (24.13%) were para 3–5. Regarding the age of these women, 7 (21.21%) were less than 25 years, 16 (48.48%) were between 25–34 years and 10 (30.30%) were between 35–45 years. Duration of surgery was between 30–45 minutes in most of the cases (96.96%). Blood loss during surgery was <100 ml, only in 1 case it was between 100–300 ml, where one unit of blood was transfused. Regarding postoperative complications only 1 case had wound sepsis. Most of the cases (93.93%) were discharged at 3rd or 4th postoperative day. No complaints were found during follow up period of 6 months. Conclusion: Abdominal sacrohysteropexy can be considered as a safe and effective treatment of uterine prolapse in young and in those women who desire to retain the uterus.Keywords: Uterine prolapse, frequency, abdominal sacrohysteropexy, young women


Diwan A, Rardin CR, Strohsnitter WC, Weld A, Rosenblatt P, Kohli N. Laparoscopic uterosacral ligament uterine suspension compared with vaginal hysterectomy with vaginal vault suspension for uterovaginal prolapse. Int Urogynecol J Palvic Floor Dysfunct 2006;17:79–83.

Vierhout M. Epidemiology of pelvic organ prolapse. Gynecology Forum 2004;9(1):7–9.

Bai SW. The role of collagen formation in pelvic floor disorder. Gynecology Forum 2004;9(1):10–2.

Kean DP, Sims TJ, Bailey AJ, Abrams P. Analysis of pelvic floor electromyography and collagen status in premenopausal nulliparous females with genuine stress urinary incontinence. Neurourol Urodyn 1992;11:308–9.

Thakar R, Stanton S. Management of genital prolapse. BMJ 2002;324:1258–62.

Raz. S, editor. Female Urology. 2nd ed. Philadelphia: WB Saunders; 1996.

Karateke A, Gurbuz A, Kabaca C, Mengulluoglu M. Sacrocervicopexy and combined operations involving cases of total uterine prolapse; Case reports. Med Princ Pract 2004;13:164–8.

Park AJ, Paraiso MF. Surgical management of uterine prolapse. Minerva Ginecol 2008;60:493–507.

Ridgeway B, Frick AC, Walter MD. Hysteropexy. A review. Minerva Ginecol 2008;60(6):509–28.

Kaminski PF, Hoffman MB and Nguyen L. Vaginectomy: Profile of success in treating Vaginal prolapse: Editorial Comment: A case for vaginal vault Reconstruction in the treatment of Genital Prolapse. http://www.medscape.com/viewarticle/421361_7

Buller JL, Thompson JR, Cundiff GW, Krueger Sullivan L, Schon Ybarra MA, et al. Uterosacral ligament: Description of anatomic relationships to optimize surgical safety. Obstet Gynecol 2001;97:873–9.

Mant J, Painter R, Vessey M. Epidemiology of genital prolapse: observations from oxford Family Planning Association study. Am J Obstet Gynecol 1997;104:579–85.

Olsen AL, Smith VJ, Bergstrom JO, Colling JC, Clark AL. Epidemiology of surgically managed pelvic organ prolapse and urinary continence. Obstet Gynecol 1997;89:501–6.

Rackley R, Vasavada S, Moore C. Laparoscopic - Assisted Vaginal tape Procedures. Available at: http://my.clevelandclinic.org/Documents/Urology/Transcript_%20Lap_Assited_POP.pdf

van Brummen HJ, van de Pol G, Aalders CI, Heintz AP, van der Vaart CH. Sacrospinous hysteropexy compared to vaginal hysterectomy as primary surgical treatment for a descensus uteri: effects on urinary symptoms. Int. Urogynecol J Pelvic floor Dysfunct 2003;14:350–5.

Benson JT, Lucente V, McClellan E. Vaginal versus abdominal reconstructive surgery for the treatment of pelvis support defects: a prospective randomized study with long term outcome evaluation. Am J Obstet Gynecol 1996;175:1418–21.

Karim F, Mushtaq M, Azaz S. Sacrohysteropexy with prolen -1 for the management of uterovaginal prolapse. Pak Armed Forces Med J 2005;55(4):314–7.

Leron E, Stanton S.L. Sacrohysteropexy with synthetic mesh for the management of Uterovaginal prolapse. BJOG 2001;108:629–33.

Dietz V, de Jong J, Huisman M, Schraffordt Koops S, Heintz P, van der Vaart H. The effectiveness of the sacrospinous hysteropexy for the primary treatment of uterovaginal prolapse. Int Urogynecol J Pelvic floor Dysfunct 2007;18:1271–6.