title: Laparoscopic hysteropexy: 10 years' experience.
abstract: OBJECTIVE
  Uterine prolapse is common and has traditionally been treated by vaginal hysterectomy. Increasingly, women are seeking uterine-preserving alternatives. Laparoscopic hysteropexy offers resuspension of the uterus using polypropylene mesh. We report on 10 years' experience with this technique.
  
  
  METHODS
  All hysteropexy procedures in our unit since 2006 were reviewed. Primary outcome was safety of hysteropexy, as assessed by intraoperative and major postoperative complications. Secondary outcomes were measures of feasibility, including operating time, length of stay, conversion to alternative procedures, change in point C, patient satisfaction, and repeat apical prolapse surgery.
  
  
  RESULTS
  Data were available for 507 women. Complications were rare (1.8%) with no evidence of any mesh exposure. Mean operating time was 62.5 min and median length of stay 2 nights. In 17 patients (3.4%), hysteropexy was abandoned. There was a mean change in point C of 7.9 cm and 93.8% of patients felt that their prolapse was "very much" or "much" better. Of these women, 2.8% have had repeat apical surgery.
  
  
  CONCLUSIONS
  To our knowledge, this is the largest series to date, describing 10 years' experience with laparoscopic hysteropexy. The surgical technique appears to be safe, with low complication rates, which supports the choice of appropriately selected women to opt for uterine preservation surgery as an alternative to hysterectomy for the management of uterine prolapse.
authors.affiliation: Department of Urogynaecology, John Radcliffe Hospital, Oxford, OX3 9DU, UK. helenjefferis@doctors.org.uk.
authors.forename: Helen
authors.identifier: http://orcid.org/0000-0002-8927-0474
authors.initials: H
authors.lastname: Jefferis
authors.affiliation: Department of Urogynaecology, John Radcliffe Hospital, Oxford, OX3 9DU, UK.
authors.forename: Natalia
authors.initials: N
authors.lastname: Price
authors.affiliation: Department of Urogynaecology, John Radcliffe Hospital, Oxford, OX3 9DU, UK.
authors.forename: Simon
authors.initials: S
authors.lastname: Jackson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D015907:Hysteroscopy / Q000009:adverse effects / Q000379:methods*; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D007902:Length of Stay; D008875:Middle Aged; D061646:Operative Time; D011126:Polypropylenes; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D012189:Retrospective Studies; D013526:Surgical Mesh; D016896:Treatment Outcome; D014596:Uterine Prolapse / Q000601:surgery*; D014599:Uterus / Q000601:surgery*
chemical_list: D011126:Polypropylenes
keywords: Laparoscopic hysteropexy; Pelvic organ prolapse; Uterine preservation