Women with uterine prolapse and concomitant enterocele who wish to avoid hysterectomy — for reasons such as preservation of fertility or maintenance of body image — can be managed with evidence-based uterine-sparing surgical repair. This clinical scenario calls for a tailored approach distinct from hysterectomy-based prolapse surgery.

Uterine prolapse complicated by enterocele in a patient who declines or wishes to defer hysterectomy. The preference may be driven by desire to preserve fertility, body image considerations, or personal beliefs regarding surgical impact on sexual function. Uterine-sparing repair is a recognised surgical option in this population, though the evidence base is less extensive than that supporting hysterectomy-based approaches.

Uterine-sparing surgical repair forms the basis of management. Available techniques involve either suspension of the uterus to supporting pelvic structures or, in carefully selected patients who no longer require vaginal coital function, an alternative obliterative approach that leaves the uterus in situ. The choice between these strategies depends on patient anatomy, fertility goals, and surgical access — the full decision framework and technique details are in the structured protocol.

References

DOI: 10.1097/AOG.0000000000003519

Hysteropexy is a viable alternative to hysterectomy in women with uterine prolapse, although there is less available evidence on safety and efficacy compared with hysterectomy.

Women who desire surgical treatment of POP may choose to avoid hysterectomy for a variety of reasons, including preservation of fertility, maintenance of body image, and beliefs about adverse effects on sexual function.

Alternatives to hysterectomy for the surgical treatment of POP include hysteropexy (ie, uterine suspension) and Le Fort colpocleisis.

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Enterocele with Uterine Prolapse: What to Do When the Patient Prefers to Avoid Hysterectomy

References