RECTUS SHEATH SLING PROCEDURE: A NEW HORIZON IN UTEROVAGINAL PROLAPSE TREATMENT
DOI:
https://doi.org/10.69656/pjp.v21i2.1801Keywords:
Rectus sheath sling, Uterovaginal descent, Uterovaginal prolapseAbstract
Background: Abdominal sacrocolpopexy offers a durable solution for pelvic organ prolapse through mesh suspension techniques. This study assessed the outcome of rectus fascial sling procedure. Methods: This single-arm interventional study was done on 50 patients with uterovaginal prolapse, in Department of Obstetrics and Gynaecology, DG Khan Medical College, DG Khan and Nishtar Medical University, Multan. PFDI-20 (Pelvic Floor Disability Index) was measured preoperatively to assess severity of symptoms. Rectus sheath sling procedure was performed. Surgical outcome was measured one year after surgery. Difference in mean PFDI-20 score before and after surgery was calculated. Results: Mean age of the patients was 27.9±11.5 years; 46 (92%) women had 2nd degree uterovaginal descent and 4 (8%) women had 1st degree prolapse. Mean time of operation was <1 hour in 46 (92%) and >1 hour in 4 (8%) of patients. Sixteen (32%) women had hospital stay of 1-2 days after the surgery and 34 (68%) women stayed for 3-4 days in the hospital. Surgical outcome was measured post operatively one year after surgery with PFDI-20. Ninety-two percent women reported no symptoms post procedure. Mean PFDI-20 score after surgery was 11.6±5.61. ?Mean PFDI-20 score was 43.4±9.4 showing substantial improvement in the symptoms after surgery. PFDI-20 score after surgery was found to be significantly associated with age (p<0.001). Conclusion: Rectus sheath sling operation for uterovaginal descent is effective, minimally invasive, and less time consuming. It can be recommended for women desiring to preserve their fertility.
Pak J Physiol 2025;21(2):25-28, DOI: https://doi.org/10.69656/pjp.v21i2.1801
Downloads
References
Choi KH, Hong JY. Management of pelvic organ prolapse. Korean J Urol 2014;55(11):693–702.
Tso C, Lee W, Austin-Ketch T, Winkler H, Zitkus B. Nonsurgical treatment options for women with pelvic organ prolapse. Nursing Womens Health 2018;22(3):228–39.
Jokhio AH, Rizvi RM, MacArthur C. Prevalence of pelvic organ prolapse in women, associated factors and impact on quality of life in rural Pakistan: population-based study. BMC Womens Health 2020;20(1):82.
Zulfiqar S, Karim S, Zulfiqar S. Modified sling procedure for treatment of uterovaginal prolapse. J Shaikh Zayed Medical Coll 2018;9(3):1467–9.
Sarwar I, Khan AB, Khurshid W, Islam A, Bibi S. Management of uterine prolapse: vaginal hysterectomy versus uterus preserving procedures. J Rehman Med Inst 2023;9(2):10–3.
Rameshkumar R, Kamat L, Tungal S, Moni S. Modified purandare’s cervicopexy—a conservative surgery for genital prolapse: a retrospective study. Int J Reprod Contracept Obstet Gynecol 2017;6(5):1777–81.
Lin FC, Gilleran JP, Powell CR, Atiemo HO. To mesh or not mesh ‘apical prolapse’, that is the question! Neurourol Urodyn 2024;43(7):1626–30.
Banu LF. Synthetic sling for genital prolapse in young women. Int J Gynaecol Obstet 1997;57(1):57–64.
Dietz V, Schraffordt Koops SE, van der Vaart CH. Vaginal surgery for uterine descent; which options do we have? A review of the literature. Int Urogynecol J Pelvic Floor Dysfunct 2009;20(3):349–56.
Rahat-un-Nisa, Parveen Z. Abdominal suspension operation for utero-vaginal prolapse using autologous facial sling of rectus sheath. J Ayub Med Coll Abbottabad 2000;12(3):29–30.
Wu JM, Matthews CA, Conover MM, Pate V, Funk MJ. Lifetime risk of stress urinary incontinence or pelvic organ prolapse surgery. Obstet Gynecol 2014;123(6):1201–6.
Gutman R, Maher C. Uterine-preserving POP surgery. Int Urogynecol J 2013;24:1803–13.
Roovers JP, van der Vaart CH, van der Bom JG, van Leeuwen JH, Scholten PC, Heintz AP. A randomised controlled trial comparing abdominal and vaginal prolapse surgery: effects on urogenital function. BJOG 2004;111(1):50–6.
Khan NA, Fayyaz A, Iqbal R, Attaullah H. Abdominal suspension operation for uterovaginal roll strip of rectus sheath as sling. Pak J Med Health Sci 2020;14(3):714–5.
Abid S, Ashraf A. Effectiveness of autologous rectus sheath sling abdominal procedure for utero-vaginal prolapse. J Akhtar Saeed Med Dent Coll 2023;5(3):125–30.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Sadia Nazir, Amna Aziz, Rashida Parveen, Amna Bibi, Abdul Rehman Qaisrani, Syeda Hina Fatima
This work is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International License.
The author(s) retain the copyrights and allow their publication in Pakistan Journal of Physiology, Pak J Physiol, PJP to be FREE for research and academic purposes. It can be downloaded and stored, printed, presented, projected, cited and quoted with full reference of, and acknowledgement to the author(s) and the PJP. The contents are published with an international CC-BY-ND-4.0 License.
