ABSTRACT

Pelvic organ prolapse during pregnancy is a rare condition. There are several case report studies in the literature on this, especially in patients with nulliparity. We presented the management and post-surgical follow-up of a case of pelvic organ prolapse that developed during pregnancy and immediately after delivery in two patients. Both of our patients with descensus uteri were young (26 and 27 years old) and had normal body mass index values, with no family history, no risk factors, and no history of trauma. Conservative treatment was preferred for our patient who was diagnosed with descensus in the third trimester of pregnancy. Pelvic organ prolapse did not regress after childbirth, as was expected. Although descensus occurred at the end of the third trimester of pregnancy in the first case, it developed during and immediately after delivery in the second case, and there was no regression there after in either case. The cervix protruded from the hymenal os in both patients’ postpartum 4th-month controls, this had a significant impact on the patients’ sexual, social, and psychological lives. Both patients had a desire to have children. Suspension surgeries using Mesh and Tape were not preferred because of the negative effects of synthetic suspension materials on the next pregnancy. Both patients underwent laparoscopic round ligament shortening and Sacrouterin ligament plication surgery. The patients were told that these operations were not permanent and that there was a possibility of sagging again afterwards. After the operation, the patients were followed up for about 2 years. In one of the patients, recurrence developed in the 19th month, 1 cm above the hymenal os. Although descensus uteri are rarely observed in young patients, the knowledge of the literature is quite limited. Unfortunately, there is no literature available to guide clinicians in the management and treatment of such health problems in young patients who want to have children. Therefore, multicenter studies including more patients are needed.