title: Transvaginal uterosacral ligament hysteropexy: a video tutorial.
abstract: OBJECTIVE
  Uterine-sparing procedures could be attractive in patients concerned about fertility preservation and corporeal image changes. Transvaginal uterosacral ligaments (USLs) hysteropexy can provide a mesh-free technique for uterine suspension. This video is intended to serve as a tutorial for surgical steps.
  
  
  METHODS
  A 38-year-old woman with symptomatic stage III POP desired preserving fertility. After proper counseling, the patient was admitted for vaginal hysteropexy through bilateral high USL suspension according to the featured technique.
  
  
  RESULTS
  Prolapse repair was successfully achieved without complications. We had already published a series of 20 cases that confirmed that transvaginal USLs hysteropexy is a promising technique for correcting genital prolapse with uterus preservation.
  
  
  CONCLUSIONS
  Transvaginal USLs hysteropexy provides a feasible technique for apical support without the use of prosthetic material. This procedure could be attractive to women who desire a uterine-sparing surgical option.
authors.affiliation: ASST Monza, Ospedale San Gerardo, Università degli Studi di Milano-Bicocca, Monza, Italy.
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Milani
authors.affiliation: ASST Monza, Ospedale San Gerardo, Università degli Studi di Milano-Bicocca, Monza, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Frigerio
authors.affiliation: ASST Valtellina e Alto Lario, Università degli Studi di Milano-Bicocca, Sondrio, Italy.
authors.forename: Federico
authors.initials: F
authors.lastname: Spelzini
authors.affiliation: ASST Monza, Ospedale San Gerardo, U.O. Ginecologia, Via Pergolesi, 33, 20900, Monza, MB, Italy. stefano.manodoro@gmail.com.
authors.forename: Stefano
authors.identifier: http://orcid.org/0000-0002-1837-0806
authors.initials: S
authors.lastname: Manodoro
mesh_terms: D000328:Adult; D005260:Female; D059247:Fertility Preservation / Q000379:methods; D006801:Humans; D008022:Ligaments / Q000601:surgery*; D059351:Organ Sparing Treatments / Q000379:methods*; D056887:Pelvic Organ Prolapse / Q000601:surgery*; D014599:Uterus / Q000601:surgery*; D014621:Vagina / Q000601:surgery*
keywords: Hysteropexy; Transvaginal route; Uterine-sparing surgery; Uterosacral ligaments suspension; Video tutorial