To describe the feasibility, safety, and outcomes of women with uterine prolapse treated with extraperitoneal sacral hysteropexy by natural orifice transluminalendoscopic surgery, NOTES.

Prospective descriptive study of patient with uterine prolapse that treated in Southwest Hospital from Dec.2016 to Dec.2017. NOTES as the primary therapy. Demographic data, perioperative outcomes and clinical efficacy were analyzed.

14 patients were identified in whom a NOTES was attempted, 13(93%) successfully underwent the procedure and 1 had converted to 3-port laparoscopy because of the rupture of the peritoneum. The median age of the patients was 49 years, the body mass index was 23.6 kg/m^2, the median operative time was 156 min, and the median operative blood loss was 100 ml. 1 cases of presacral hemorrhage were successfully treated by bipolar coagulation. Preoperative POP-Q score was Aa: 0, Ba: 1, C: 2, Ap: -3, Bp: -3. The average follow-up period of 10 months after operation, POP-Q score: Aa: -2, Ba: -2, C: -7, Ap: -3, Bp: -3.Related symptoms disappeared or obviously improved, no sexual discomfort, no erosion, exposure, infection and other complications. The rate of objective cure was 100%.

NOTES is feasible, safe and effective in the treatment of uterine prolapse, but further clinical studies are needed to assess its complete clinical application.