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Cited by 80Pelvic floor disorders treatmentsUterine Myomas and TreatmentsGynecological conditions and treatments

Does prolapse equal hysterectomy? The role of uterine conservation in women with uterovaginal prolapse

Ridgeway, Beri M.·2015·American Journal of Obstetrics and Gynecology
DOI 10.1016/j.ajog.2015.07.035
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Abstract

Hysterectomy has historically been a mainstay in the surgical treatment of uterovaginal prolapse, even in cases in which the removal of the uterus is not indicated. However, uterine-sparing procedures have a long history and are now becoming more popular. Whereas research on these operations is underway, hysteropexy for the treatment of prolapse is not as well studied as hysterectomy-based repairs. Compared with hysterectomy and prolapse repair, hysteropexy is associated with a shorter operative time, less blood loss, and a faster return to work. Other advantages include maintenance of fertility, natural timing of menopause, and patient preference. Disadvantages include the lack of long-term prolapse repair outcomes and the need to continue surveillance for gynecological cancers. Although the rate of unanticipated abnormal pathology in this population is low, women who have uterine abnormalities or postmenopausal bleeding are not good candidates for uterine-sparing procedures. The most studied approaches to hysteropexy are the vaginal sacrospinous ligament hysteropexy and the abdominal sacrohysteropexy, which have similar objective and subjective prolapse outcomes compared with hysterectomy and apical suspension. Pregnancy and delivery have been documented after vaginal and abdominal hysteropexy approaches, although very little is known about outcomes following parturition. Uterine-sparing procedures require more research but remain an acceptable option for most patients with uterovaginal prolapse after a balanced and unbiased discussion reviewing the advantages and disadvantages of this approach.

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Crossref · 10.1016/j.ajog.2015.07.035

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  • Uterine-preserving surgery involving suspension of the uterus is an increasingly popular alternative to hysterectomy with vaginal vault suspension for treating pelvic organ prolapse.

    “Uterine-preserving surgery involving suspension of the uterus is an increasingly popular alternative to the traditional use of hysterectomy with vaginal vault suspension to treat pelvic organ prolapse”

    From Hysterectomy versus uterine preservation for pelvic organ prolapse surgery: a prospective cohort study (2025) · cites this paper as [9]

  • Hysterectomy is the mainstay of primary POP surgery to access pelvic ligaments and tissues for vaginal suspension even when the uterus is not prolapsed.

    “Hysterectomy is the mainstay of primary POP surgery to access pelvic ligaments and tissues for vaginal suspension even when the uterus is not prolapsed.9”

    From Hysterectomy versus uterine preservation for pelvic organ prolapse surgery: a prospective cohort study (2025) · cites this paper as [9]

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Authors
Ridgeway, B. M.
Affiliations
Cleveland Clinic (US)
Corresponding author
Ridgeway, Beri M.
ORCID
Ridgeway, Beri M.
Venue
American Journal of Obstetrics and Gynecology
Publisher
Elsevier BV
Published
2015-12
Volume
213
Issue
6
Pages
802-809
ISSN
0002-9378 (ISSN-L)
DOI
10.1016/j.ajog.2015.07.035
OpenAlex
W1568546807
Cited by
80
References
36
Citations by year
2026: 1 · 2025: 10 · 2024: 12 · 2023: 5 · 2022: 3 · 2021: 5 · 2020: 12 · 2019: 6 · 2018: 10 · 2017: 6 · 2016: 9 · 2015: 1
FWCI
7.26
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • American Journal of Obstetrics and Gynecology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Rheumatology › Pelvic floor disorders treatments
  • Health Sciences › Medicine › Obstetrics and Gynecology › Uterine Myomas and Treatments
  • Health Sciences › Medicine › Obstetrics and Gynecology › Gynecological conditions and treatments
Keywords
uterovaginal prolapse, uterus-sparing surgery, hysteropexy, hysterectomy, sacrohysteropexy, apical suspension, fertility preservation, postmenopausal bleeding, postoperative outcomes
MeSH terms
Contraindications, Female, Humans, Hysterectomy, Pregnancy, Pregnancy Outcome, Gynecologic Surgical Procedures, Uterine Neoplasms, Uterine Prolapse, Sexuality, Patient Preference, Organ Sparing Treatments

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