Modified purandare’s cervicopexy-a conservative surgery for genital prolapse: a retrospective study

摘要

Background: Purandare described a technique for the surgical treatment of genital prolapse in young women in 1965. This technique of cervicopexy is easy to perform and provides dynamic support to the uterus. The objective of study is to evaluate the role of modified Purandare’s cervicopexy in the treatment of genital prolapse in reproductive age group and to study the pregnancy outcome and fertility in patients who have undergone modified Purandare’s sling surgery. Methods: Between January 2007 and December 2015, 20 women in the reproductive age (mean age 30.5 years, range 24 to 37 years) underwent modified Purandare’s cervicopexy at Shree Dharmasthala Manjunatheshwara (SDM) College of Medical Sciences, Dharwad, India. Of these, 2 (10%) patients were nulligravida, 7 (35%) were primipara and 11 (55%) were multigravida. Four (20%) women had associated infertility. Additional surgeries like tubectomy were performed in 4 (20%) women, tubal patency test in 3 (15%), ovarian drilling in 2 (10%) and myomectomy in 2 (22.2%) women, and cystocele repair was done in 4 women (20%). Results: All 20 patients were analysed for intraoperative and postoperative complications. All were followed up for mean duration of 12 months. There were no reported intra or post-operative complications. Out of 4 infertile women, 2 conceived spontaneously 6 months after the surgery. Of these, one delivered successfully at term by lower segment caesarean section and other by normal vaginal delivery. One woman conceived 8 months after the surgery spontaneously, antenatally followed for 3 months and then later was lost to follow-up. There was no recurrence of prolapse. Conclusions: Nulliparous prolapse can be treated by various surgical procedures, each having their own merits and de-merits. Our modification of Purandare’s cervicopexy is simple, effective and is less technically demanding.