Anterior abdominal wall cervicopexy for treatment of stage III and stage IV uterine prolapse.
OBJECTIVE
To study the operative and postoperative outcomes of anterior abdominal wall cervicopexy (AWC) for treatment of stage III and stage IV uterine prolapse.


METHODS
AWC was performed by anchoring the supravaginal cervix to the anterior abdominal wall. This was done following obliteration of the pouch of Douglas via laparotomy.


RESULTS
Among 37 patients, AWC was performed in 21 women with stage III and 16 women with stage IV uterine prolapse. Overcorrection was observed in 3 women. Postoperatively, 2 women experienced febrile morbidity and 5 had urinary retention. Thirteen women complained of urinary frequency, but all reported improvement at 3-month follow up. Among 24 women who became pregnant, 14 delivered vaginally, 5 delivered by cesarean, and 5 had an ongoing pregnancy. Four recurrences occurred: 2 stage II and 2 stage III prolapses. Three of these women had delivered by cesarean, while the fourth recurrence occurred after the patient's third vaginal birth.


CONCLUSIONS
AWC is a simple and effective procedure to treat stage III and stage IV uterine prolapse. However, some surgical modifications and more studies are required to ascertain its validity.
Salem
Hosam T
HT
Women's Health University Center, Department of Obstetrics and Gynecology, Faculty of Medicine, Assiut University, Assiut, Egypt.
Tawfik
Reda M
RM
El Saman
Ali M
AM
Nasr
Ahmed
A
D000293:Adolescent; D000328:Adult; D002584:Cervix Uteri / Q000601:surgery*; D002585:Cesarean Section; D005260:Female; D005500:Follow-Up Studies; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D011247:Pregnancy; D018873:Pregnancy Rate; D013536:Suture Techniques; D016055:Urinary Retention / Q000209:etiology; D014596:Uterine Prolapse / Q000601:surgery*; D055815:Young Adult