The success rate and quality of life following three types of uterine sparing prolapse surgery

Uterine prolapse has been traditionally treated with vaginal hysterectomy and cuff suspension. Recently there is renewed interest in uterine conservation during prolapse surgeries. This study was performed with aim to evaluate the success rate and quality of life in women following one of three types of uterine sparing prolapse surgery.

This retrospective study was performed in Tehran Imam Khomeini Hospital in 2019. The data of 99 patients with uterine prolapse who underwent one of three types of uterine sparing surgery (Manchester, Sacrospinus Hysteropexy, Abdominal sacral Hysteropexy) during three years were reviewed and compared in terms of success rate and quality of life. 99 patients completed a valid questionnaire of quality of life after prolapse surgeries (Pelvic Floor Distress Inventory-20). The success rate after 12 months was evaluated as a primary outcome and the complications such as repeat surgery, using pessary  and feeling mass were evaluated as secondary outcomes. Data were analyzed by SPSS software (version 22) and ANOVA, Kruskal-Wallis and Chi-square tests were used. P < 0.05 was considered statistically significant.

The success rate of sacral hysteropexy was higher than two other groups (about 94%).The highest recurrence was in sacrospinous, in the Ba point ( -2.06± 0.506) and C point (-2.1±1.084) (p<0.01). The quality of life was similar in the Manchester and sacral hysteropexy group and was higher than sacrospinous group. Early complications after sacral hysteropexy were ileus and defecatory disorder.

All three uterine sparing prolapse surgeries had success rate of higher than 60%. All three surgical groups had a good quality of life and satisfaction 12 months after the procedure. The highest recurrence was in sacrospinous in Ba and C points. Finding mesh complications following sacral hysteropexy surgery requires long-term follow-up.