Less Intrusive Abdominal Wall Organopexy As Surgical Treatment for Stage III and IV Genital Prolapse

Bushra Zulfiqar

Abstract

Objective

To document the outcome of abdominal wall organopexy (cervicopexy) for stage III and IV genital prolapse.

Study design

Observational cross-sectional study.

Place & Duration of study

Fatima Bai Hospital Karachi, from October 2019 to July 2022.

Methods

Patients of reproductive age group having stage III and IV genital prolapse assessed by POP-Q classification were included. AWO was performed by affixing the cervix at internal os to the rectus sheath using polypropylene sutures to uplift the anterior vaginal wall through abdominal wall route.  

Results

Total of 30 patients underwent abdominal wall organopexy (cervicopexy) for stage III and IV uterine prolapse, twenty (66.6%) patients had associated risk factors for the prolapse that included multiparity in 25 (83.3%) and in 18 (60%) patients’ history of lifting heavy weight was reported. Seventeen (56.67%) patients had BMI between 26 – 30 Kg/m2. In 23 (76.6%) patients operating time was between 15-20 minutes. Postoperatively, 26 (86.6%) had early recovery. Postoperatively 21 (70%) patients reported using contraceptive methods. Out of nine patients who tried for pregnancy, 02 (6.7%) conceived and delivered by cesarean sections. No patient reported uterine prolapse recurrence after two years of follow up.  

Conclusion

The surgical procedure performed was less invasive, easy to perform, with minimum postoperative complications and satisfactory mid-term follow up for genital prolapse of stage III and IV.

Key words

Abdominal wall organopexy, Genital prolapse, Uterine prolapse, Cervicopexy.