Key words: uterine prolapse, hysteropexy, practice pattern variation

"Hysteropexy in the treatment of uterine prolapse"

The research described in this dissertation was aimed at the treatment of uterine prolapse. The most important motivation for this dissertation was to investigate whether a relatively new method (hanging up the uterus by means of keyhole surgery) was just as effective in correcting the prolapse as hanging up the uterus by via the vagina, an intervention that is frequently carried out in the Netherlands. Secondly, the dissertation was aimed at mapping the practice pattern variation in the treatment of prolapse in the Netherlands. A large variation in practice was found per hospital and per region. Also a large variation in the execution of some prolapse operations was found. It was shown that keyhole surgery is not less effective in resolving uterine prolapse compared to vaginal surgery. More research is needed into the treatment of uterine prolapse (surgical versus non-surgical, different surgical techniques using keyhole surgery) to minimize the risk of recurrence and to improve patients' quality of life as much as possible.