Uterine Prolapse – means the uterus lacks support because the original supporting ligaments known as the uterosacral ligaments have broken. When the ligaments break, the uterus prolapses along with the vaginal vault (aka apex). This is a common phenomenon among women of all ages but most commonly associated with women who have had childbirth. Dr’s Miklos and Moore recommend a hysteropexy or keeping the uterus in most cases of uterine prolapse.
The traditional recommended surgical treatment for uterine prolapse is a hysterectomy ( ie removal of the uterus). In the past, there were many reasons why surgeons adhered to this treatment and rarely took into account the patient’s disposition of retaining her uterus. Dr Miklos & Moore realize it is a woman’s right to make decisions about her uterus and ovaries and will do everything possible to respect the rights and wishes of the woman with respect to her uterus and ovaries. The “gold standard” operation for supporting the uterus and/or vaginal vault is the sacral colpopexy and Dr Miklos & Moore have the largest medically published series in the world on the operation. (Click here to read the article). Not only is it the largest published series in the world for sacral colpopexy/hysteropexy, Dr Miklos & Moore do the operation through miniature incisions (ie laparoscopy) whereas most surgeons do the procedure through a large abdominal incision known as a laparotomy.
Though some people have reservations about using mesh for uterine suspension Dr. Miklos’ & Moore’s paper on sacral colpopexy will illuminate how rare these complications are. The sacral colpopexy is without a doubt the BEST OPERATION ever developed for uterine and vaginal vault suspension. So why don’t more people do it laparoscopically, they just are not capable. They lack training and the skill to perform the procedure in a safe fashion. Utilizing a sacral colpopexy to preserve the uterus can be known by many different names including: sacral colpopexy, sacral colpohysteropexy, hysteropexy, sacral promontofixation, uterine suspension and uterine preservation. Patients should understand that the sacral colpopexy can be performed with or without the uterus in place. Dr. Miklos & Moore also respect a woman’s decision NOT TO have mesh for this procedure and will do the surgery as requested by the patient after first making them an informed consumer (i.e. informing patient of the risks, benefits, complications and alternatives available.)