Laparoscopic uterine suspension by round ligament plication

Area of Science:

• Minimally invasive gynecological surgery
• Pelvic pain management
• Female reproductive health

Background:

• Chronic pelvic pain (CPP) affects many women, often linked to conditions like uterine retroversion.
• Uterine retroversion can cause discomfort and pain, necessitating effective treatment options.
• Surgical interventions aim to correct uterine position and alleviate associated symptoms.

Purpose of the Study:

• To present a standardized laparoscopic technique for uterine suspension via round ligament plication.
• To evaluate the efficacy of this method in treating chronic pelvic pain due to uterine retroversion.

Main Methods:

• A retrospective review of 46 women who underwent laparoscopic uterine suspension for CPP over five years.
• The procedure involved round ligament plication using standard laparoscopic suturing instruments.
• Patients were followed for a mean of 23.6 months, with pain assessed pre- and post-operatively.

Main Results:

• No intraoperative complications were reported in the series of 46 patients.
• At six months post-surgery, 96% of patients reported pain improvement, with 37% experiencing significant improvement and 39% reporting pain resolution.
• Long-term follow-up showed sustained benefits, with 59% at 24 months and 65% at 36 months reporting significant improvement or resolution of pain.

Conclusions:

• Laparoscopic round ligament plication is an effective surgical option for uterine suspension.
• This technique successfully repositions the uterus and significantly reduces or resolves chronic pelvic pain associated with uterine retroversion.
• The procedure offers a safe and effective minimally invasive solution for women suffering from CPP due to uterine malposition.