Transabdominal uterosacral suspension: outcomes and complications

Objective: The objective of the study was to report outcomes and complications following abdominal uterosacral suspension (AUSS) for treatment of pelvic organ prolapse. Study Design: This was a surgical case series of consecutive women who underwent AUSS between 2002 and 2005. Results: One hundred seven women underwent AUSS using permanent suture (mean age, 55 years; range, 32-83; and mean follow-up, 21; range, 3-74 months). Concomitant surgery included hysterectomy (99%), continence procedures (14%), and anterior and posterior colporrhaphy (9%). In the 75 patients who completed 1 year of follow-up, 9 patients (12%) reported recurrent or persistent symptoms of prolapse and 5 patients (7%) had objective anatomic failure. Complications were few, with the most common complication being erosion of the apical suspension sutures, which occurred in 9% at an average time of 56 (range, 3-75) months. Conclusion: An AUSS successfully suspends the cuff for treatment of prolapse and may be offered prophylactically to women who are undergoing abdominal hysterectomy for nonprolapse indications. Alternative sutures may reduce the suture erosion rate.