International Clinical and Medical Case Reports Journal (ISSN: 2832-5788) | Volume 2, Issue 17 | Research Article | Open Access DOI
Nawal Al Harbi*
Nawal Al Harbi*, Aisha Alshitwi, Hana Al Madani and Khalida Alotaibi
Maternity Hospital, King Saud Medical City, Riyadh, Saudi Arabia
*Correspondence to: Nawal Al Harbi
Fulltext PDFUterine Prolapse/Pelvic Organ Prolapse (pop), is a common complaint in women presenting in outpatient gynecology clinics. It occurs when pelvic floor muscles and ligaments stretch and weaken because of multiple childbirth, obesity, or age. This weakening of the support structures allows the uterus to move out of its normal position and drop into the vagina. The mainstay of treatment for symptomatic prolapse is surgical. Sling operations repair prolapse by reinforcing damaged suspensory ligaments, whereas mesh sheet operations block organ prolapses. Different modalities of sling surgery are reported in the literature.
The purpose of this case series is to show the benefit of abdominal suspension operation using Mersilene tape sling for conservative surgical management of uterine prolapse in women during reproductive life. The technique is simple and Mersilene tape is safer than mesh which carries serious complications.
Methods:Retrospective case records analysis was performed of total 20 patients who had abdominal sling surgery with Mersilene tape for management of second and third degree uterine prolapse, at Maternity Hospital, King Saud Medical City, Riyadh, Saudi Arabia from 1996 – 2022. The parity varies from para 1 to para 8 and the follow-up was different among patients from one month postoperatively until 15 years.
The procedure is to support uterus by Mersilene tape. The tape is attached to uterosacral ligament and cervix posteriorly, then pulled in between broad ligament leaves retroperitoneally and fixed with non-absorbable black silk sutures on the lower anterior aspect of rectus sheath (Figure 1).
Results:All patients had follow-up after one month of the operation had successful correction of their prolapse with no complications. Thirteen patients had followed up till one year with no recurrence. One patient had followed up after two years while she was pregnant and delivered by caesarean section with no complications or recurrence. One patient had followed up at gynecology clinic for postmenopausal complaint after 15 years of surgery and was found to have no recurrence of uterine prolapse. However, 5 patients had no show after the first month of postoperative follow up.
Conclusion: Abdominal sling surgery using Mersilene tape for conservative surgical management of second and third degree uterine prolapse is worth to be done for young women with uterine prolapse or older one who want to preserve their uterus. It has high success rate with less time consuming and negligible blood loss, in addition to preserving fertility in women during reproductive life. This technique is easier and carries less complications than posterior sling to sacral promontory. Moreover, Mersilene tape is a safe alternative to mesh which carries serious complications.
Conservative surgical management second and third degree uterine prolapse; Abdominal sling surgery; Mersilene tape; posterior cervix and Uterosacral ligament; Rectus sheath
Nawal Al Harbi, Aisha Alshitwi, Hana Al Madani and Khalida Alotaibi.Conservative Surgical Management of Uterine Prolapse Using Mersilene Tape Sling, Case Series and Literature Review. Int Clinc Med Case Rep Jour. 2023;2(17):1-6.