Transposition of cardinal ligaments for stages II–III uterine prolapse: A minimally invasive procedure

Abstract

Uterine and other pelvic organ prolapse (POP) are becoming more frequently encountered due to increased life expectancy among menopausal women. Traditionally, most surgical procedures included hysterectomy as an integral part of the management. POP might, however, though less commonly, affect women not willing to accept hysterectomy, especially young females who did not complete their family. For these patients, uterine prolapse could be managed by a number of uterine-sparing surgical procedures that are performed through either abdominal or vaginal route according to patient's condition, surgeon's choice, and skills. Most of these operations, however, are usually lengthy, invasive, need good experience, and sometimes special accessories and instruments. We performed anterior transposition of the cardinal ligaments on two patients with POP quantification Stages II-III uterine prolapse without amputating the cervix. Both patients were interviewed at 6, 12, and 18-month intervals and reported no undue pain or dyspareunia with complete satisfaction regarding self-assessment of gynecologic anatomy. Furthermore, examination by the lead author revealed satisfactory anatomic correction. We recommend this simple, easy, and minimally invasive vaginal procedure to fellow gynecologists for repair of mild degrees of uterine prolapse in women declining hysterectomy or amputation of the cervix.

Keywords

• Cardinal ligaments
• pelvic organ prolapse
• uterine-sparing surgery
• vaginal approach