Uterosacral–cardinal ligament stretching prior to vaginal hysterectomy increases uterine descent: a novel technique

Abstract

Objective To examine the effect of uterosacral–cardinal ligament complex stretching prior to vaginal hysterectomy on uterine descent. Study design A prospective trial of 25 consecutive women undergoing vaginal hysterectomy. Pre-operative, apical, anterior and posterior wall POP-Q measurements were recorded for each patient before and after uterosacral–cardinal ligament complex stretching during general anesthesia. Results Uterosacral–cardinal ligament complex stretching yielded a significant increase in mean stage of uterine and anterior wall descent (2.6 ± 0.6 vs. 3.2 ± 0.6 cm, p < 0.001, and 2.5 ± 0.8 vs. 2.9 ± 0.8 cm, respectively, p < 0.004). There was no significant change in posterior wall prolapse measurements (1.3 ± 0.7 vs. 1.4 ± 0.8 cm, p = 0.05). Conclusion Uterosacral–cardinal ligament complex stretching prior to vaginal hysterectomy increase uterine descent.