Consequences and treatment options in rectum diastasis. A treatment algorithm suggestion

Abstract

Introduction and objectives: Diastasis recti is defined as a separation of the rectus abdominis, associated to a general weakness of the anterior abdominal wall. So far, it has been considered a merely cosmetic problem, being repaired during an abdominoplasty. In this study we seek to review the current literature about the association between diastasis recti and diverse functional alterations, the surgical techniques used to repair it and its indications. Material and methods: A search in Ovid and Pubmed has been done, using the MESH terms “diastasis of the rectum”, “divarication of the rectum” and “diastasis recti”, selecting only articles in English, French and Spanish, without date restrictions. Results: We describe the diverse functional consequences that patients suffering diastasis recti refer, discussing their possible association, and the most frequently used techniques to treat it, highlighting each one's indications in case there is evidence about it. Conclusions: Diastasis recti does not seem to be related significantly to low back pain, urinary incontinence or other symptoms. None of the surgeries used show superiority in repairing it, and neither are their indications clearly defined. We propose a treatment algorithm based on literature published so far, until more evidence is available.