Uterine-preserving vaginal sacrospinous hysteropexy in pelvic organ prolapse: a case series

Pelvic organ prolapse (POP) is a major cause of morbidity among women worldwide and is commonly managed by hysterectomy. However, uterine-preserving procedures such as vaginal sacrospinous hysteropexy (SSH) are increasingly being adopted, particularly where cultural and psychological considerations make uterine conservation desirable. We report our experience with SSH in Northern Nigeria as a case series. This series involved 26 women with symptomatic POP who underwent SSH between 2015 and 2024 across different locations in Northern Nigeria. The mean age of the women was 40 years and the modal parity was 2, with most women presenting with advanced prolapse (POP-Q stage IV). All women reported protrusion per vaginam as their main complaint. The mean operating time was 31 minutes, mean blood loss was 171 mL, and mean duration of hospital stay was three days. Early complications were recorded in two patients (7.6%): one case each of postoperative bleeding and urinary retention. Recurrence was observed in two patients (7.6%) during follow-up. Outcomes were comparable to those reported in similar studies, with relatively short operative times, low blood loss, and acceptable recurrence rates. Our findings suggest that SSH is a safe, effective, and culturally acceptable option for uterine preservation in women with advanced POP in low-resource settings. Wider use of this technique could improve access to surgical care and enhance the quality of life of affected women, particularly where resources and surgical expertise are limited.