High uterosacral ligament vault suspension at vaginal hysterectomy: Objective and subjective outcomes of a modified technique

Aims:  To evaluate the outcomes of a modified high uterosacral ligament suspension (HUSLS) performed at vaginal hysterectomy for uterine prolapse. Methods:  Prolapse was assessed pre- and postoperatively in 53 consecutive women, using Baden–Walker Halfway and Pelvic Organ Prolapse Quantification systems. Sexually active women completed the Prolapse and Incontinence Sexual Function Questionnaire at follow up. The technique involves placement of one HUSLS suture on each side without a fascial reconstruction. Results:  Preoperatively, 37 (66%) women had at least Grade 2 prolapse of the cervix. At mean follow–up of 15 months, 45 (85%) had no vault prolapse and 7 (13%) had Grade 1 prolapse. Nineteen (36%) women were sexually active at follow up and completed the Prolapse and Incontinence Sexual Function Questionnaire. Mean scores for pain, vaginal tightness, partner perception of tightness and vaginal length were 2.8, 3.2, 4.0, and 3.8 respectively, indicating excellent function. Conclusions:  We report excellent objective, subjective and sexual function outcomes following this modified HUSLS.