Sacrocervicopexy and combined operations involving cases of total uterine prolapse. Case reports.

OBJECTIVE To determine the outcome of sacrocervicopexy and combined operations in the treatment of uterovaginal prolapse in women with desire to preserving both uterus and fertility. CLINICAL PRESENTATION AND INTERVENTION Sacrocervicopexy with Prolene mesh and combined operations were performed in 3 women with total uterine prolapse because of the patient's desire to retain fertility in 2 cases and refusal of hysterectomy in the 3rd patient. The 1st case was a 38-year-old woman, gravida 2, parity 1; the 2nd case a 42-year-old woman, gravida 3, parity 2, and the 3rd a 39-year-old woman, gravida 1, parity 1. Douglas pouch was obliterated with Moschcowitz operation. All of the women underwent sacrocervicopexy with Prolene mesh. The repair of a paravaginal defect and prophylactic Burch urethropexy were accomplished through entering Retzius' space. Genital hiatus was narrowed via approximating levator muscles transvaginally. No serious intraoperative complications occurred and no recurrence was detected during the follow-up period. There was no postoperative complication except for some degree of pain in the 1st postoperative month in 1 case. CONCLUSION The results indicate that sacrocervicopexy and repair of all concomitant defects in the pelvic floor are effective procedures in the treatment of uterovaginal prolapse in cases where there is a desire to retain fertility and uterus.