Uterine preservation surgery options

Uterosacral ligament uterine suspension

This is a mesh free surgery to re-suspend the uterus using a patient’s own tissue to reinforce the existing ligament that has been damaged or weakened as a result of childbirth. This surgery is usually performed laparoscopically or via a robotic approach. Figure (a) illustrates pelvic side view and inlet view where sutures are passed through the uterosacral ligaments. The uterus is elevated after tightening the sutures on the ligament  (Figure b)

Sacrohysteropexy

Uterine conservation prolapse surgery to suspend the uterus using either synthetic mesh or patient’s own graft (autologous fascia lata) from the front of sacrum. This surgery is usually performed laparoscopically or via a robotic approach and reserved for women with advanced pelvic organ prolapse or failed previous prolapse surgery. The illustration demonstrates uterine suspension technique with the use of Surgical Pelvic Organ Prolapse (SPOP) device for approximately 4 weeks.

Vaginal repair reinforced with autologous fascia lata

A standard vaginal repair will be performed and reinforced with autologous fascia lata. The graft will be extended to both sacrospinous ligament for additional support of the upper vagina and uterus. This surgery is typically reserved for patients with advanced or recurrent vaginal prolapse.