Sacrohysteropexy is a surgical procedure to correct

uterine prolapse Uterine prolapse is when the uterus descends towards or through the opening of the vagina. Symptoms may include vaginal fullness, pain with sex, trouble urinating, urinary incontinence, and constipation. Often it gets worse over time. Low back pa ...

. It involves a resuspension of the prolapsed uterus using a strip of synthetic mesh to lift the uterus and hold it in place. It allows for normal

sexual function Sexual function is how the body reacts in different stages of the sexual response cycle, or as a result of sexual dysfunction. Relevant aspects of sexual function are defined on the basis of a modified version of Masters and Johnson's work. The aspe ...

and preserves childbearing function. __TOC__

Procedure

Sacrohysteropexy can be performed as an open operation or

laparoscopically Laparoscopy () is an operation performed in the abdomen or human pelvis, pelvis using small Surgical incision, incisions (usually 0.5–1.5 cm) with the aid of a camera. The laparoscope aids diagnosis or therapeutic interventions with a few ...

(via keyhole incisions). The advantages of laparoscopic approach include superior visualisation of the anatomy with laparoscopic magnification, decreased hospital stay, reduced postoperative pain, more rapid recovery and smaller incisions. The aim of laparoscopic hysteropexy is to restore and reinforce normal uterine support by suspending the

uterus The uterus (from Latin ''uterus'', plural ''uteri'') or womb () is the organ in the reproductive system of most female mammals, including humans that accommodates the embryonic and fetal development of one or more embryos until birth. The uter ...

from the

sacral promontory The sacrum (plural: ''sacra'' or ''sacrums''), in human anatomy, is a large, triangular bone at the base of the spine that forms by the fusing of the sacral vertebrae (S1S5) between ages 18 and 30. The sacrum situates at the upper, back part ...

using

polypropylene Polypropylene (PP), also known as polypropene, is a thermoplastic polymer used in a wide variety of applications. It is produced via chain-growth polymerization from the monomer propylene. Polypropylene belongs to the group of polyolefins and ...

mesh. The mesh is strongly attached at two points: namely the uterus/

cervix The cervix or cervix uteri (Latin, 'neck of the uterus') is the lower part of the uterus (womb) in the human female reproductive system. The cervix is usually 2 to 3 cm long (~1 inch) and roughly cylindrical in shape, which changes during ...

and the anterior longitudinal

ligament A ligament is the fibrous connective tissue that connects bones to other bones. It is also known as ''articular ligament'', ''articular larua'', ''fibrous ligament'', or ''true ligament''. Other ligaments in the body include the: * Peritoneal li ...

over the sacral promontory. Hysteropexy restores the normal support of the

vagina In mammals, the vagina is the elastic, muscular part of the female genital tract. In humans, it extends from the vestibule to the cervix. The outer vaginal opening is normally partly covered by a thin layer of mucosal tissue called the hymen ...

, suspending the uterus back in its anatomical position by reinforcing weakened ligaments with a mesh. This procedure allows the length of the vagina to be restored without compromising its calibre, and is therefore likely to have a favourable functional outcome.

Outcomes

The advantages of this operation over

hysterectomy Hysterectomy is the surgical removal of the uterus. It may also involve removal of the cervix, ovaries (oophorectomy), Fallopian tubes (salpingectomy), and other surrounding structures. Usually performed by a gynecologist, a hysterectomy may b ...

, as well as preservation of

fertility Fertility is the capability to produce offspring through reproduction following the onset of sexual maturity. The fertility rate is the average number of children born by a female during her lifetime and is quantified demographically. Fertili ...

, are a stronger repair, with less risk of recurrent prolapse. Cuts to the vagina itself are also avoided so it is likely there is less risk of subsequent sexual problems.

References

{{Urogenital surgical procedures Gynecological surgery pt:Cirurgia ginecológica