A NEWMETHOD IN APPROACHING UTERINE PROLAPSE “ANCHORING UTERINE ISTHMUSWITH A STRIP AT THE RECTUS ABDOMINAL MUSCLE SHEATH, SABA NAHEDD PROCEDURE”

摘要

The uterus prolapse means the uterus descents into the vaginal axis and outside it, accompanied by the movement, to the same direction, of the vagina walls and the adjacent portions of the urinary bladder and rectum. Materials and methods: A total of 54 cases with the new surgical procedure for anchoring uterine isthmus with strip at the rectus abdominal muscle were hospitalized and operated in “Polizu” Hospital between 25.10.2012 and 26.06.2015. These cases were hospitalized with a diagnosis of uterine prolapse in 2nd and 3rd degree cystocele per - magna, which after clinical and laboratory investigations “mictional cystography” fractional biopsy curettage, resection with cervical loop diathermy to exclude associated pathology especially neoplasia, were surgically solved. In the 54 cases, we performed a new therapeutic method for resolving uterine prolapse: “Anchoring uterine isthmus with a strip at the rectus abdominal muscle sheath, procedure Saba N”. For this procedure I have invented a kit: Saba’s Strips which contains: a special isthmic strip, sub urethral strip, S & N clamp for anchoring isthmus. The technical procedure which resolves this problem consists of: anchoring the isthmic strip on the back of the uterine isthmus and the free part of the strip is fixed on the front of the isthmus in order to prevent the slipping, so all the weight of the uterus is supported by the strip as a hammock, the second strip is attached to the suburethral junction and then anchored to the rectus abdominal muscle sheath by counter suprapubic incision. So the repositioning of the uterus in anatomical, intermedian position without opening rectovaginal space not to train elitro-rectocele. Conclusions: The technique has the advantage of a complete and effective surgical treatment of uterine prolapsed in 2nd and 3rd degree and cystocele per magna because: it solves the uterus prolapse and cystocele per magna and brought it back to its anatomical position; placing the uterus in the intermediary, normal, position avoids the extension of rectovaginal space and consequently prevents the occurrence of rectocele and elitrocel; it solves incontinence effort by using suburethral strip; use of the polypropylene material that fits the unabsorbable threads rectus abdominal sheath, independent tissue hormone, makes the chances of recurrence to become the smallest possible or almost nonexistent, in the 54 cases of replacement it was “zero”. Surgical approach is exclusively vaginal avoiding incidents and accidents when opening peritoneal cavity.