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Laparoscopic
hysteropexy effectively but temporarily corrects the uterine position to
attenuate the possibility of postoperative adhesions in women with posterior deep infiltrating endometriosis (DIE).
The Retrodisplacement of the uterus can be corrected
transitorily with the help of laparoscopic hysteropexy to overcome the risk of
postoperative adhesions. Retrodisplacement (retroversion or retroflexion) of
the uterus is a condition in which uterus instead of forward position, curves
backwards at the cervix. The condition is significantly related to posterior
deep infiltrating endometriosis (DIE) and pelvic pain. Various prior studies
showed evidence regarding hysteropexy efficacy to provide relief from pelvic
pain symptoms. This study aimed to discover clinical, surgical along with
sonographic outcomes of hysteropexy technique among forty‐two symptomatic
females with uterine retrodisplacement and DIE. The women went through
laparoscopic round ligament plication and tilting of the uterine fundus.
Transvaginal and transperineal approaches were used for collecting sonographic
data of each (uterine mobility, the angle of uterine version and uterine flexion)
before and after the surgery. Pain, surgical complications and intraoperative
data were measured at one, six months and one year postoperatively.
The hysteropexy procedure was completed in about 8 ± 3 min.
Both retroversion or retroflexion were reduced significantly at the early
follow-up (P < 0.001). During the one year follow-up, 12 patients noted with
retroflexed, seven patients with retroverted angles and four patients observed
with the negative sliding sign. The symptoms showed considerable improvement
during the follow-up (P < 0.001). This reflects a good efficacy power of
laparoscopic hysteropexy as an additional surgical procedure to correct uterus
positionings and alleviates related symptoms.
Aust N Z J Obstet Gynaecol
Transvaginal and transperineal ultrasound follow-up after laparoscopic correction of uterine retrodisplacement in women with posterior deep infiltrating endometriosis
Renato Seracchioli et al.
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