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±0.6cm, p <0.001, and 2.5±0.8 vs. 2.9±0.8cm, respectively, p <0.004). There was no significant change in posterior wall prolapse measurements (1.3±0.7 vs. 1.4±0.8cm, p =0.05). Conclusion: Uterosacral–cardinal ligament complex stretching prior to vaginal hysterectomy increase uterine descent. [Copyright &y& Elsevier]