Abdominal sling surgery is defined as attachment of either the connective tissue graft (fascia lata) or some synthetic material (
Mersilene) to the anterior wall of the exposed vaginal vault following total
hysterectomy or to the posterior wall of the uterine cervix in total and subtotal
uterine prolapse, whereas the other end is attached to the anterior longitudinal ligament extending along the anterior surface of the vertebrae. Our analysis comprised 45 operations: 20 cases of
vaginal vault prolapse following
vaginal hysterectomy; 7 cases of
vaginal vault prolapse following HTA: 2 cases of
prolapse following subtotal
hysterectomy; 3 cases of nondefined TH; 2 cases following Burch operation; 1 following Kocher; 1 following Manchester, 1 following Neugebauer-Le Fort operation in which HTA was performed 2 times. Abdominal sling operation was associated with the following
surgical procedures: sling in 13 cases, sling + douglasorrhaphy in 16 cases, sling + douglasorrhaphy + colpoperineoplastics in 6 cases, sling + colpoperineoplastics in 9 cases and sling + marshall marcetti in 1 case. Recurrence of
enterocele was recorded in 5 patients in whom closure of the douglas pouch had not been performed. This procedure was therefore later included into our approach to the operation. The abdominal sling operation has been a logical and physiologic approach to surgical
therapy of genital
prolapse, particularly of the
vaginal vault prolapse following total
hysterectomy. This operation ensures subsequent normal sexual relations.