Abstract
In recent years, pelvic floor surgeons have increasingly repaired pelvic organ prolapse around an intact uterus. Uterine conservation and hysteropexy have been driven by patient preference, less risk of mesh erosion, shorter operative time, and decreased blood loss and postoperative pain. We present a case series of patients with cervical elongation after vaginal sacrospinous hysteropexy using polypropylene mesh arms, a novel technique developed by the senior author. We defined cervical elongation as greater than or equal to a two-fold increase in cervical length compared with preoperative measurements. Of the 8 patients who underwent this procedure, 5 (62.5 %) had cervical elongation during the first year postoperatively. In the most severe case, the cervix extended to 4 cm beyond the hymenal ring. Most of the patients were mildly symptomatic and chose expectant management. The cases are reviewed in detail. A brief literature review on cervical elongation is presented.
This is a preview of subscription content, log in via an institution to check access.
References
Zucchi A, Lazzeri M, Porena M, Mearini L, Costantini E (2010) Uterus preservation in pelvic organ prolapse surgery. Nat Rev Urol 7(11):626–633
Cvach K, Geoffrion R, Cundiff GW (2012) Abdominal sacral hysteropexy: a pilot study comparing sacral hysteropexy to sacral colpopexy with hysterectomy. Female Pelvic Med Reconstr Surg 18(5):286–290
Frick AC, Barber MD, Paraiso MF, Ridgeway B, Jelovsek JE, Walters MD (2013) Attitudes toward hysterectomy in women undergoing evaluation for uterovaginal prolapse. Female Pelvic Med Reconstr Surg 19(2):103–109
Nicolau-Toulouse V, Tiwari P, Lee T, Cundiff GW, Geoffrion R (2013) Does bilateral sacrospinous fixation with synthetic mesh recreate nulliparous pelvic anatomy? An MRI evaluation. Female Pelvic Med Reconstr Surg (in press)
Berger MB, Ramanah R, Guire KE, DeLancey JO (2012) Is cervical elongation associated with pelvic organ prolapse? Int Urogynecol J Pelvic Floor Dysfunct 23(8):1095–1103
Vierhout M, Fütterer J (2012) Extreme cervical elongation after sacrohysteropexy. Int Urogynecol J Pelvic Floor Dysfunct. 24(9):1579–1580
Ramanah R, Berger MB, Chen L, Riethmuller D, DeLancey JO (2012) See it in 3D! Researchers examined structural links between the cardinal and uterosacral ligaments. Am J Obstet Gynecol 207:437.e1–7
Ibeanu OA, Chesson RR, Sandquist D, Perez J, Santiago K, Nolan TE (2010) Hypertrophic cervical elongation: clinical and histological correlations. Int Urogynecol J Pelvic Floor Dysfunct 21(8):995–1000
Consent
Written informed consent was obtained from the patients for publication of this case series and any accompanying images.
Conflicts of interest
None.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Hyakutake, M.T., Cundiff, G.W. & Geoffrion, R. Cervical elongation following sacrospinous hysteropexy: a case series. Int Urogynecol J 25, 851–854 (2014). https://doi.org/10.1007/s00192-013-2258-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00192-013-2258-9