Laparoscopic Uterine Suspension for Relief of Chronic Pelvic Pain

Transabdominal uterine suspension is advocated for the management of chronic pelvic pain, deep dyspareunia, and dysmenorrhea in women with retroverted uterus when medical therapy fails to provide relief. However, concerns exist regarding the abdominal incision and the postoperative adhesion formation that occurs with the procedure. We managed 30 women with chronic pelvic pain, deep dyspareunia, and dysmenorrhea associated with retroversion of the uterus by laparoscopy. Uterine suspension was obtained by suturing both round ligament to the rectus fascia. Before the suspension, other procedures were performed, including lysis of adhesions and excision or vaporization of endometriosis. During follow-up of 6 months to 5 years, 80% of patients reported improvement of pain. We conclude that in selected patients with these disorders, laparoscopic uterine suspension is effective in relieving pain, and is safe, effective, and timesaving procedure.