Abdominal Approaches to Uterine Suspension

Severe uterine descensus or symptomatic uterine retroversion are conditions requiring surgical treatment in many cases. Abdominal uterine suspension can be offered to patients who have not completed childbearing or to a select group of older patients who request uterine preservation. Surgeons may prefer these procedures to shorten the length of the operation when there is no uterine pathology. A review of abdominal and laparoscopic procedures for uterine suspension and their complications is presented in this article. Many of the procedures are not commonly practiced by contemporary pelvic surgeons and are described principally for historic interest. We currently recommend abdominal sacral hysteropexy as the optimal approach for preserving the uterus while treating prolapse.