Case Reports

A Laparoscopic Conservative Surgery Approach to Puerperium Complicated by Uterine Prolapse After Vaginal Delivery: A Case Series

Abstract

Objective: In fertile women, hysterocele is a rare condition. Genital prolapse can be treated conservatively with laparoscopic hysterosacropexy. It is objected to present a successful case series of laparoscopic hysteropexy for patients with hysterocele after vaginal delivery.
Case report: We presented a successful case series of three patients with III or IV degrees of hysterocele who were treated conservatively with an uncomplicated laparoscopic hysteropexy within a year of delivery. Given our patients' young ages and the fact that they all have infant children at home, we chose a conservative surgery performed laparoscopically due to the lower surgical impact and quicker return to normal life. All surgical procedures were successfully performed, without complications, with a prompt recovery of all women and with a regular subsequent follow-up, without recurrence nowadays.
Conclusion: For young women who have not terminated their desire to bear children, laparoscopic hysterepexy may be a safe and effective surgical option.

1. Troiano L, Pregazzi R, Bortoli P, Madai M. Post-partum urogenital and perineal prolapse. Minerva Ginecol 2000; 52(7-8):299-305.
2. Tegerstedt G, Miedel A, Mæhle-Schmidt M, Nyrén O, Hammarström M. Obstetric risk factors for symptomatic prolapse: a population-based approach. American journal of obstetrics and gynecology 2006; 194(1):75-81.
3. Fayyad AM, Siozos CS. Safety and one year outcomes following vaginally assisted laparoscopic uterine sacropexy (VALUES) for advanced uterine prolapse. Neurourol Urodyn 2014; 33(3):345–9.
4. Wilcox LS, Koonin LM, Pokras R, Strauss LT, Xia Z, Peterson HB. Hysterectomy in the United States, 1988−1990. Obstet Gynecol 1994; 83(4):549–55.
5. Price N, Slack A, Jackson SR. Laparoscopic hysteropexy: the initial results of a uterine suspension procedure for uterovaginal prolapse. BJOG 2010; 117(1):62–8.
6. Rahmanou P, White B, Price N, Jackson S. Laparoscopic hysteropexy: 1- to 4-year follow up of women postoperatively. Int Urogynecol J 2014; 25(1):131-8.
7. Demirci F, Kuyumcuoglu U, Api M, Uludogan M. Longitudinal vaginal septum: an unusual cause of postpartum total uterine prolapse. J Pak Med Assoc. 1995 Aug;45(8):221-2.
8. Adegoke TM, Vragovic O, Yarrington CD, Larrieux JR. Effect of pregnancy on uterine-sparing pelvic organ prolapse repair. International Urogynecology Journal 2020; 31(3):657-62.
9. Korbly NB, Kassis NC, Good MM, et al. Patient preferences for uterine preservation and hysterectomy in women with pelvic organ prolapse. American journal of obstetrics and gynecology 2013; 20995):470-e1.
10. Frick AC, Barber MD, Paraiso MF, et al. Attitudes toward hysterectomy in women undergoing evaluation for uterovaginal prolapse. Female Pelvic Med Reconstr Surg 2013; 19(2):103-109.
11. Meriwether KV, Balk EM, Antosh DD, et al. Uterine-preserving surgeries for the repair of pelvic organ prolapse: a systematic review with meta-analysis and clinical practice guidelines. International urogynecology journal 2019; 30(4):505-22.
12. Coolen AL, van Oudheusden AM, Mol BW, et al. Laparoscopic sacrocolpopexy compared with open abdominal sacrocolpopexy for vault prolapse repair: a randomised controlled trial. International Urogynecology Journal 2017; 28(10):1469-79.
13. White WM, Goel RK, Swartz MA, et al. Single-port laparoscopic abdominal sacral colpopexy: initial experience and comparative outcomes. Urology 2009; 74(5):1008-12.
14. Paraiso MF, Walters MD, Rackley RR, et al. Laparoscopic and abdominal sacral colpopexies: a comparative cohort study. Am J Obstet Gynecol 2005; 192(5):1752-8.
15. Higgs PJ, Chua HL, Smith AR. Long term review of laparoscopic sacrocolpopexy. BJOG: An International Journal of Obstetrics & Gynaecology 2005; 112(8):1134-8.
16. Geller EJ, Siddiqui NY, Wu JM, Visco AG. Short-term outcomes of robotic sacrocolpopexy compared with abdominal sacrocolpopexy. Obstet Gynecol 2008; 112(6):1201-6.
17. Klauschie JL, Suozzi BA, O'Brien MM, McBride AW. A comparison of laparoscopic and abdominal sacral colpopexy: objective outcome and perioperative differences. International Urogynecology Journal 2009; 20(3):273-9.
18. De Gouveia De Sa M, Claydon LS, Whitlow B, Dolcet Artahona MA. Laparoscopic versus open sacrocolpopexy for treatment of prolapse of the apical segment of the vagina: a systematic review and meta-analysis. International Urogynecology journal 2016; 27(1):3-17.
19. Gutman RE, Rardin CR, Sokol ER, et al. Vaginal and laparoscopic mesh hysteropexy for uterovaginal prolapse: a parallel cohort study. Am J Obstet Gynecol 2017; 216(1):38.e1.
20. Illiano E, Giannitsas K, Costantini E. Comparison between laparoscopic sacrocolpopexy with hysterectomy and hysteropexy in advanced urogenital prolapse. Int Urogynecol J 2020; 31(10):2069-74.
Files
IssueVol 17, No 1 (March 2023) QRcode
SectionCase Reports
DOI https://doi.org/10.18502/jfrh.v17i1.11980
Keywords
Hysterocele Vaginal Prolapse Laparoscopy Laparoscopic Hysteropexy Hysterosacropexy

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How to Cite
1.
Seca M, Algeri P, Colonna L, Mastrocola N, Von Wunster S. A Laparoscopic Conservative Surgery Approach to Puerperium Complicated by Uterine Prolapse After Vaginal Delivery: A Case Series. J Family Reprod Health. 2023;17(1):58-61.