title: Uterine preservation for advanced pelvic organ prolapse repair: Anatomical results and patient satisfaction.
abstract: OBJECTIVE
  The aims of the current study were to evaluate outcomes and patient satisfaction in cases of uterine prolapse treated with vaginal mesh, while preserving the uterus.
  
  
  METHODS
  This is a retrospective cohort study that included all patients operated for prolapse repair with trocar-less vaginal mesh while preserving the uterus between October 2010 and March 2013. Data included: patients pre-and post-operative symptoms, POP-Q and operative complications. Success was defined as prolapse < than stage 2. A telephone survey questionnaire was used to evaluate patient's satisfaction.
  
  
  RESULTS
  Sixty-six patients with pelvic organ prolapse stage 3, including uterine prolapse of at least stage 2 (mean point C at+1.4 (range+8-(-1)) were included. Mean follow-up was 22 months. Success rate of the vaginal mesh procedure aimed to repair uterine prolapse was 92% (61/66), with mean point C at -6.7 (range (-1) - (-9)). No major intra-or post-operative complication occurred. A telephone survey questionnaire was conducted post-operatively 28 months on average. Ninety-eight percent of women were satisfied with the decision to preserve their uterus. Eighteen patients (34%) received prior consultation elsewhere for hysterectomy due to their prolapse, and decided to have the operation at our center in order to preserve the uterus.
  
  
  CONCLUSIONS
  Uterine preservation with vaginal mesh was found to be a safe and effective treatment, even in cases with advanced uterine prolapse. Most patients prefer to keep their uterus. Uterus preservation options should be discussed with every patient before surgery for pelvic organ prolapse.
authors: Bar Ilan University - Faculty of health, Safed, Israel.
authors: Keshet
authors: K
authors: Fink
authors: Bar Ilan University - Faculty of health, Safed, Israel.|Ziv Medical Center - Ob/Gyn, Safed, Israel.
authors: Inbar Ben
authors: IB
authors: Shachar
authors: Bar Ilan University - Faculty of health, Safed, Israel.|Ziv Medical Center - Ob/Gyn, Safed, Israel.
authors: Naama Marcus
authors: NM
authors: Braun
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects; D008875:Middle Aged; D059351:Organ Sparing Treatments / Q000706:statistics & numerical data*; D017060:Patient Satisfaction; D056887:Pelvic Organ Prolapse / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology; D012189:Retrospective Studies; D013526:Surgical Mesh; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress; D014599:Uterus / Q000601:surgery
keywords: Autonomic Nervous System; Pelvic Organ Prolapse; Uterus