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Management of uterine prolapse: is hysterectomy necessary?
Author(s) -
Jefferis Helen,
Jackson Simon Robert,
Price Natalia
Publication year - 2016
Publication title -
the obstetrician and gynaecologist
Language(s) - English
Resource type - Journals
eISSN - 1744-4667
pISSN - 1467-2561
DOI - 10.1111/tog.12220
Subject(s) - medicine , hysterectomy , uterine prolapse , gynecology , infertility , fertility , obstetrics , general surgery , surgery , pregnancy , population , environmental health , biology , genetics
Key content Management of uterine prolapse is currently heavily influenced by patient and surgeon preferences. The traditional approach to uterine prolapse is vaginal hysterectomy. However, this does not address the underlying deficiency in connective tissue pelvic floor support, and prolapse recurrence is common. Uterine preservation surgery is increasing in popularity, both with surgeons and patients; there is currently little evidence to show superior outcome to hysterectomy. Fertility preservation remains the one absolute indication for hysteropexy. Other potential advantages include stronger apical support and reduced vaginal surgery. Colpocleisis remains a valid option for a small cohort of patients.Learning objectives Options for the management of uterine prolapse. How to help patients decide on a management plan.