title: Anterior abdominal wall cervicopexy for treatment of stage III and stage IV uterine prolapse.
abstract: 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.
authors.affiliation: Women's Health University Center, Department of Obstetrics and Gynecology, Faculty of Medicine, Assiut University, Assiut, Egypt.
authors.forename: Hosam T
authors.initials: HT
authors.lastname: Salem
authors.forename: Reda M
authors.initials: RM
authors.lastname: Tawfik
authors.forename: Ali M
authors.initials: AM
authors.lastname: El Saman
authors.forename: Ahmed
authors.initials: A
authors.lastname: Nasr
mesh_terms: 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