Abstract

Sling surgery for pelvic organ prolapse in low setting resources: A case series

Author(s): Uzma Kausar*, Hena Saiyda

Background: India has the largest prevalence of nulliparous prolapse and it is no surprise that Indian gynecologists have devised most of the conservative operations for genital prolapse. It is important to look at certain important aspects of the supporting sling Virkrud 14 classification of sling operations. This study was undertaken to assess the procedures of modified abdominal sling itself and its results.

Material and methods: Modified abdominal sling operation for conservative surgery for uterocervical descent is performed in twenty women of M.R.A. medical college Ambedkar nagar. The procedure is difficult and bold but is the perfect anatomical solution to strengthen weak uterosacral ligaments with the help of a mercelene. We have performed 25 cases of modified abdominal sling surgeries in obstetrics and gynaecology department from 2015 to 2022 of MRA medical college, Ambedkar nagar, India. Of these, 1 (04%) patient were nulligravida, 7 (35%) were primipara and 12 (48%) were multigravida. Four (16%) women had associated infertility. Additional surgeries like tubectomy were performed in 2 (08%) women, ovarian drilling in 4 (16%) and myomectomy in 1 (12.2%).

Results: All 25 patients were analyzed for intraoperative and postoperative complications. All were followed up for mean duration of 12 months. Out of 4 infertile women, 2 conceived spontaneously 6 months after the surgery and 6 primipara were conceived spontaneously within a year. There was no recurrence of prolapse.

Conclusions: Nulliparous prolapse can be treated by various surgical procedures, each having their own merits and de merits. Modified abdominal sling is the real corrective solution to weekend uterosacral ligaments. It is the perfect anatomical solution for conservatives’ approach to uterocervical descent.