Pitsillidi Anna, Vona Laura, Bettocchi Stefano, Schiermeier Sven, Noé Günter Karl
Department of OB/GYN, Rheinland Klinikum Dormagen, Dr.-Geldmacher-Straße 20, 41540 Dormagen, Germany.
Department of Medical and Surgical Sciences, Institute of Obstetrics and Gynaecology, University of Foggia, 71122 Foggia, Italy.
J Clin Med. 2025 Apr 17;14(8):2777. doi: 10.3390/jcm14082777.
Nowadays, there is an increasing desire among women suffering from pelvic organ prolapse (POP) to choose a uterus-sparing surgical treatment in order to preserve their fertility. The objective of this study was to conduct a systematic review of the literature to assess how pregnancy and delivery affect the recurrence of POP in women who had previously undergone laparoscopic hysteropexy as well as to improve and individualise the future counselling of patients of reproductive age desiring uterine-preserving treatment for POP. : A comprehensive literature review was conducted using the MEDLINE (PubMed), Web of Science, and Scopus databases for articles published until January 2025, without previous historical limits. The research strategy adopted included different combinations of the following terms: hysteropexy, pregnancy, laparoscopy, and prolapse. : A total of ten case reports and three case series met the inclusion criteria for the review, comprising 26 patients. All authors used laparoscopic sacral hysteropexy (LSHP) for the treatment of POP. All patients underwent caesarean delivery at a mean gestational age of 38 weeks. Over a mean follow-up period of 9 months, only 4% of patients developed a recurrent uterine prolapse. A total of 8% of the patients developed de novo anterior compartment prolapse, 8% developed a recurrence of anterior compartment prolapse, and 4% developed posterior compartment prolapse. : LSHP seems to be a safe option for women of reproductive age with incomplete family planning, as it does not seem to negatively impact foetal growth. Pregnancy does not appear to affect the long-term efficacy of hysteropexy in maintaining apical support. Given the limited data on the safety and efficacy of uterine-sparing surgery for POP followed by a subsequent pregnancy, further evidence is of great importance towards evaluating safety, efficacy, and providing better counselling for women.
如今，患有盆腔器官脱垂（POP）的女性越来越希望选择保留子宫的手术治疗以保留生育能力。本研究的目的是对文献进行系统综述，以评估妊娠和分娩如何影响先前接受腹腔镜子宫固定术的女性POP的复发情况，并改善和个性化对希望接受保留子宫治疗POP的育龄患者的未来咨询。：使用MEDLINE（PubMed）、科学网和Scopus数据库对截至2025年1月发表的文章进行了全面的文献综述，没有先前的历史限制。所采用的研究策略包括以下术语的不同组合：子宫固定术、妊娠、腹腔镜检查和脱垂。：共有10篇病例报告和3个病例系列符合综述的纳入标准，包括26名患者。所有作者均采用腹腔镜骶骨子宫固定术（LSHP）治疗POP。所有患者均在平均孕周38周时进行剖宫产。在平均9个月的随访期内，只有4%的患者出现复发性子宫脱垂。共有8%的患者出现新的前盆腔脱垂，8%的患者出现前盆腔脱垂复发，4%的患者出现后盆腔脱垂。：对于计划生育不完全的育龄女性，LSHP似乎是一种安全的选择，因为它似乎不会对胎儿生长产生负面影响。妊娠似乎不会影响子宫固定术在维持顶端支撑方面的长期疗效。鉴于关于POP保留子宫手术后随后妊娠的安全性和有效性的数据有限，进一步的证据对于评估安全性、有效性以及为女性提供更好的咨询非常重要。
