Uterine prolapse – preservation or excision?

The pathological cause of uterine prolapse is loss of integrity of the uterosacral and cardinal ligament complex and a weakening of the pelvic floor diaphragm. Uterine descent is a consequence rather than the cause of pelvic organ prolapse. However vaginal hysterectomy is an operation which is commonly performed to treat uterine prolapse. Does the uterus need to be removed? The advent of minimally invasive surgical techniques and a shift towards patient centred care is leading surgeons to question the need to remove the uterus. This article examines the facts and evidence behind the debate.