Combined laparoscopic uterosacral and round ligament procedures for treatment of symptomatic uterine retroversion and mild uterine decensus.

Study Objective: To evaluate the efficacy of a new modified technique to treat a symptomatic retrodisplaced uterus.

Design: Prospective clinical study (Canadian Task Force classification II-2).

Setting: Tertiary care university hospital.

Patients: Thirty-one women with symptomatic uterine retrodisplacement but without significant pelvic pathology.

Intervention: Laparoscopic shortening and plication of uterosacral ligaments with modified Gilliam suspension.

Measurements And Main Results: In average follow-up of 3.3 +/-1.0 years, all patients had an anteverted, anteflexed uterus. Mean +/- SD operating time was 24.1 +/- 4.7 minutes. There were no complications during or after surgery. Dyspareunia scores before and after surgery were 5.4 +/- 1.4 and 0.5 +/- 0.7, respectively (p <0.001). Chronic pelvic pain was satisfactorily relieved in seven of nine women. Vagina lengths before and after surgery were 5.9 +/- 0.7 and 7.0 +/- 0.3 cm, respectively (p <0.001).

Conclusion: Our technique achieved long-lasting good results in suspending uteri in anteverted, anteflexed position and relieved symptoms caused by retrodisplacement.