Is hysterectomy necessary for the treatment of utero-vaginal prolapse?

Abstract

The standard surgical procedure for uterovaginal prolapse is vaginal hysterectomy and reconstruction of the uterosacral ligaments. Women who wish to have further children are generally advised to delay surgery until their family is complete. Some women may still wish to consider treatment before family completion if symptoms are severe and others may wish to conserve the uterus for personal reasons. In addition hysterectomy has specific risks, may be a causative factor in subsequent bladder symptoms and does not specifically cure the prolapse. A variety of other surgical procedures to conserve the uterus have been described and many show high rates of symptom improvement in the short term. Fertility after conservative surgery for prolapse is unknown as very few pregnancies have been reported in the literature after such surgery.