[The role of hysterectomy during the repair of prolapse by promonotofixation].

In the past, hysterectomy was routinely performed at the time of pelvic organ prolapse repair. Nowadays, in patients with abnormal uterus (fibroma, dysplasia...), hysterectomy should be performed at the time of surgery. In contrast, in young women especially with desire of childbearing, uterus preservation is the best choice. But there is still a debate in postmenopausal patients with normal uterus and POP. There is currently no argument for choosing hysterectomy or uterus preservation at the time of POP repair in regard of the anatomical results for the middle as well as the anterior and posterior compartments. But it has been proven that hysterectomy increased the perioperative morbidity. Subtotal hysterectomy decreases this morbidity and result in a decreased rate of mesh erosion. To date, literature is not conclusive about the impact of hysterectomy on lower urinary tract symptoms. Patient's counselling is important before hysterectomy with adequate information about potential psychosexual consequences of such procedure. At least, if uterus preservation, patients must be aware of the risk of malignant diseases (cervix or endometrial carcinoma) even if the risk is low in case of a good screening preoperatively.