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Purpose of Review <p>Pelvic organ prolapse (POP) affects nearly 40% of women, with approximately 13% requiring surgery. Historically, hysterectomy was standard in prolapse repair, but evolving evidence has prompted a shift toward uterine preservation. This review examines whether uterine-preserving prolapse procedures (UPPS) offer outcomes comparable to hysterectomy-based approaches and explores factors influencing surgical decisions, including patient preferences and surgical innovations.</p> Recent Findings <p>Recent randomized trials and meta-analyses are non-inferior to hysterectomy based surgeries in terms of anatomical success, recurrence, and patient satisfaction. Advantages include shorter operative time, less blood loss, fertility preservation, and psychological benefits. However, hysterectomy remains necessary for malignancy, abnormal bleeding, or anatomic distortion.</p> Summary <p>Uterine preservation is a safe, effective, and increasingly preferred option in the management of POP. For appropriately selected patients, it offers comparable outcomes to hysterectomy while honoring reproductive goals and self-identity. Shared decision-making remains critical, balancing patient values with individualized surgical planning.</p>

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Management of the Uterus During Prolapse Surgery: Hysterectomy vs Uterine Preservation

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年2月28日

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  • Tamar Yacoel,
  • Christina Yarborough,
  • Katherine Amin,
  • Raveen Syan

摘要

Purpose of Review

Pelvic organ prolapse (POP) affects nearly 40% of women, with approximately 13% requiring surgery. Historically, hysterectomy was standard in prolapse repair, but evolving evidence has prompted a shift toward uterine preservation. This review examines whether uterine-preserving prolapse procedures (UPPS) offer outcomes comparable to hysterectomy-based approaches and explores factors influencing surgical decisions, including patient preferences and surgical innovations.

Recent Findings

Recent randomized trials and meta-analyses are non-inferior to hysterectomy based surgeries in terms of anatomical success, recurrence, and patient satisfaction. Advantages include shorter operative time, less blood loss, fertility preservation, and psychological benefits. However, hysterectomy remains necessary for malignancy, abnormal bleeding, or anatomic distortion.

Summary

Uterine preservation is a safe, effective, and increasingly preferred option in the management of POP. For appropriately selected patients, it offers comparable outcomes to hysterectomy while honoring reproductive goals and self-identity. Shared decision-making remains critical, balancing patient values with individualized surgical planning.