Laparoscopic Preliminary Experience in Pelviscopic Uterine Suspension Using Webster-Baldy and Franke's Method

Objective

To find which method gives the best relief from dyspareunia and pelvic pain caused by a retroverted uterus using the two methods mentioned as compared to other methods reported in the medical literature.

Subjects

Twenty-five patients, with ages ranging from 25-55 years old, complaining of mild to severe pelvic pain and dyspareunia seeking treatment in our OPD were evaluated and treated in a span of 3 years time.

Methods

Pelviscopic retrouterine ligament fixation using Webster-Baldy and Franke's method were done after each patient was evaluated as to the uterine position, degree of misalignment of the uterus and severity of adhesion. Pelvic pain and dyspareunia were reproduced by palpation of the retroverted uterus. Ultrasonographies were performed to confirm initial findings and to rule out any ovarian or uterine abnormalities. Orthopedic and psychological consultations were done to rule out any orthopedic disorders or non-organic causes of their problem.

Results

Of the twenty -five patients treated, 20 patients were treated using Webster-Baldy method and five patients were treated using Franke's method, all the patients (100%) experienced great improvement 6 weeks after the operation. After 6 months, 16 patients (80%) with the Webster-Baldy method and four patients (80%) with the Franke's method had complete relief from pelvic pain and dyspareunia. The remaining four patients (20%) with the former method and one patient (20%) with the latter method complained of mild abdominal discomfort. After 6 months to two years of follow-up, 17 patients with the Webster-Baldy method and five patients with Franke's method had improved sexual life and the remaining three patients were lost to follow-up.

Conclusion

When dyspareunia and pelvic pain are caused by a retroverted method, we believe uterine suspension using different procedures will certainly relieve this problem. We have presented and have chosen these two procedures mainly due to their simplicity and the almost nil possibility of bowel intussusception into the anterior cul-de-sac as compared to other methods.