Sacrohysteropexy followed by successful pregnancy and eventual reoperation for prolapse

A multitude of uterine-sparing prolapse repairs exist in the literature, but little is published on subsequent pregnancy and long-term success following a repair. A 35-year-old gravida 2 para 2 underwent laparoscopic sacrohysteropexy and suburethral sling for stage III prolapse and stress urinary incontinence. She conceived 6 months postprocedure. Her antepartum course was complicated by third trimester pelvic pressure--successfully managed with a pessary. She delivered via cesarean section at term. At 12 months postpartum she had no signs of prolapse. Two years postpartum, she reprolapsed and underwent robotic assisted laparoscopic supracervical hysterectomy, sacrocolpopexy, and perineorrhaphy. Two years postoperatively she remained without any prolapse symptoms. Laparoscopic sacrohysteropexy is a reasonable surgical option for patients with pelvic organ prolapse considering future pregnancies.