Fascial Sling of the Rectus Abdominis Muscle in theTreatment of Vaginal Prolapse after Hysterectomy

Overview

Objective:
Evaluation of results of vaginal vault suspension by means of fascial sling of rectusmuscle sheath in total prolaps situation after hysterectomy.Setting: Department of operative gynaecology and minimally invasive surgery, Na Homolce Hospital, Prague, Czech Republic.Design: Retrospective analysis of nine surgeries.Methods: The records and operative experiences of nine patients were analysed, in particular inrelation to complications, blood loss, success rate, age and type of previous hysterectomy. For thefixation of rectus sheath slings the retroperitoneal access was used and the surgery was concluded by Moschcowitz culdoplasty.Results: No pre- and postoperative complications were encountered. The blood losses were notmeasurable. The mean operation time was 92 minutes (range 84 - 101 min.). So far all the patientsare without recurrence, the mean follow - up is relatively short (through 2,6 years, range 1 - 4years). The choice of surgical access in this difficult area of gynaecological surgery will largelydepend on the preference of the surgeon and his expertise. In the case of abdominal routepreference in certain cases the use of fascial sling of rectus sheath should also seriously beconsidered as an alternative to abdominal sacrocolpopexy.

Key words:
vaginal vault prolaps, abdominal and vaginal hysterectomy, fascial sling of rectusmuscle sheathv