Laparoscopic uterine suspension by round ligament plication.

OBJECTIVE: To describe a method for laparoscopic uterine suspension by round ligament plication using standard suturing instruments. STUDY DESIGN: Forty-six women underwent uterine suspension for treatment of chronic pelvic pain due to uterine retroversion over a period of five years. All operations were performed by the principal author. RESULTS: Forty-six patients treated with this technique were selected from 388 who underwent clinical evaluation and diagnostic laparoscopy for chronic pelvic pain, defined as lasting more than six months. There were no intraoperative complications in this series. Mean follow-up was 23.6 months (range, 6-42). At each follow-up, patients were asked to rate their pain relative to preoperatively as unchanged, minor, moderate, significant or resolved. At six months, 44 of 46 patients (96%) reported at least some improvement, with 17 (37%) reporting significant improvement, and 18 (39%) reporting resolution of pain. Sixteen of 27 patients (59%) at 24 months' follow-up and 15 of 23 patients (65%) with 36 months' follow-up reported significant improvement in or resolution of their pain. CONCLUSION: For patients experiencing chronic pelvic pain associated with uterine retroversion, round ligament plication is an effective method of repositioning the uterus and reducing or eliminating the patient's symptoms.