Is hysterectomy or the use of graft necessary for the reconstructive surgery for uterine prolapse?

The aim of this study was to evaluate whether hysterectomy or the use of graft is necessary for the reconstructive surgery for uterine prolapse. One hundred sixty-eight patients were categorized into the 3 groups: group I, abdominosacral colpopexy with mesh and hysterectomy (n=63); group II, abdominosacral uteropexy with mesh (n=35); group III, abdominal uterosacrocardinal colpopexy and hysterectomy (n=70). Perioperative and postoperative complications, functional outcomes, and anatomical recurrences were assessed. The median follow-up was 36 months in all surgery groups. In the complication rates and functional outcomes, no difference was noted, except for operation time (longer in group I, p=0.001) and hemoglobin loss (greater in group II, p=0.002). There was a significant difference in the cumulative anatomical cure rates (p<0.0001). The risk of recurrence in group III was 6.2 times higher than in group I. In conclusion, the use of graft, rather than hysterectomy, might be necessary for the reconstructive surgery for uterine prolapse.