Trans-obturator Sling for the Treatment of UterineProlapse (A Pilot Novel Approach)

Objective: To innovate a technique for management of uterine prolapse stages 2, 3 or 4. The aim is to preserve the uterus in an effective way. Vaginal hysterectomy is sti the most frequently used operation for the uterine descent worldwide. However the new technique restores the normal anatomical condition of the uterus efficiently.

Methods: A pilot novel study procedure, which was carried out at Al Azhar University in Egypt, between March 2012 and December 2015. 20 women were complaining of symptomatic uterine prolapse stage 2, 3 or 4. They were treated by transobturator sling with uterine conservation. Patients were then reviewed after the surgery after 1 week, 1 month, 6 months intervals and then yearly thereafter.

Results: 20 patients underwent innovative transobturator sling operation with uterine conservation. 19 out of the 20 procedures were successful, with no objective evidence of uterine prolapse on clinical examination after 2 to 4 years of reviews. Significant subjective remarkable improvements in prolapse symptoms, urinary stress incontinence, vaginal infection, itching, ulcers, sexual wellbeing and vaginal prolapse. Within the follow up period, two patients conceived and gave birth.

Conclusion: The new transobturator sling operation is an effective, simple, safe, and secure and time saving (around 20 minutes) treatment that could benefit patients, who suffer of uterine prolapse. Results show, it is a better procedure compared to abdominal or laparoscopic sling operation. It avoids the potential morbidity of vaginal hysterectomy and has a very high success rate (95 %).