Abstract
Author(s): Belma Gozde Ozdemir, Meltem Aydogdu, Betul Dik, Gorkem Aktas, Leyla Huseynli, Gunay Safarova, Ahmet Bilgi, Mustafa Gazi Ucar, Cetin Celik
Background: Following a hysterectomy, the incidence of cuff prolapse is 3.2%, whereas among women who have not undergone a hysterectomy, the prevalence is 2%. This difference is significant, as the uterine ligaments play a crucial role in maintaining the uterus's position. The ligament structure is disrupted by the aging process, which also affects the extracellular matrix and metalloproteinase activity. However, anatomic loss of support structure happens following a hysterectomy. Apical prolapse and subsequent scar tissue may be avoided by stabilizing sutures to the uterosacral ligament's cuff. Apical prolapse and subsequent scar tissue may be avoided by stabilizing sutures to the uterosacral ligament's cuff. Our goal was to draw attention to the significance of "Uterosakral Ligament Plication" (USLP) surgery in preventing cuff prolapse following hysterectomy. Material/Methods: A retrospective study was conducted, evaluating all cases that underwent total abdominal hysterectomy for benign or malignant reasons between 2010 and 2024. Among these, patients who developed cuff prolapse and underwent surgery for this reason were identified. Patients who underwent USLP and those who did not were categorized. The total number of patients who underwent hysterectomy was 2033, the number of patients who underwent USLP was 832, and the cuff was closed with continuous locking in 1201 patients. Results: According to these data, there was a statistically significant difference in the rates of vaginal cuff prolapse between the two groups (p<0.05). The incidence of cuff prolapse is higher when the USLP technique is not added. Conclusion: Applying USLP to close the vaginal cuff, which is an easy and applicable method, may be a preventive step against cuff prolapse.