Autologous rectus sheath sling for treatment of vault prolapse after hysterectomy.

Abstract

Objective: Determine the duration and post-operative complications of surgery in patients who underwent rectus sheath sling for correction of vault prolapse. We started doing this novel technique and found it very safe with least side effects so wanted to study it. Study Design: Experimental study. Setting: Nishtar Hospital Multan Pakistan. Period: July 2016 to June 2018. Material & Methods: Patients were applied autologous sling of rectus sheath at Nishtar Hospital Multan and were followed for 2 years. Patients with diabetes mellitus and any other chronic disease were excluded. Patients who had previous surgery for vault prolapse were also excluded from the study. Data were recorded and analyzed using IBM-SPSS version 23.0, percentages are given for previous surgery duration (how long before the previous surgery was done), duration of  current surgery, post-operative fever, post -operative urinary tract infection(UTI), duration of stay in the hospital after surgery, parenteral analgesia requirement.  Parameters were tested using Pearson Chi Square test with type of previous surgery. Results: The total number of patients in the study were 19.The mean age of the patients was 59.7 years (SD = ±9.7) and mean weight was 59.4kg (SD = ±12.5). The duration of surgery was less than 1 hour in 84 % of patients. Same percentage had less than 36 hours requirement of post- operative parenteral analgesia and thus less than 2 days of post-operative stay in hospital. Postoperatively 31.6 % had fever, 26.3% had Urinary tract infection. On 2 years follow-up of this surgery, no patient had any recurrence of vault prolapse and 85.7% showed no coital difficulty. Conclusion: This surgical procedure is a simple, time saving method with less complications and is best suited for low resource countries like Pakistan.