Diastasis recti abdominis: A comprehensive review

Abstract

BACKGROUND: Diastasis recti abdominis (DRA) refers to the separation of the rectus abdominis muscles along the linea alba. Though traditionally viewed as a postpartum cosmetic issue, DRA has functional implications and affects both women and men. METHODS: A comprehensive literature review was conducted using PubMed, Web of Science, and Google Scholar, identifying 355 relevant publications over the past two decades. Priority was given to high-quality studies including randomized trials, observational studies, systematic reviews, and meta-analyses. RESULTS: DRA is highly prevalent in postpartum and menopausal women, and increasingly recognized in males with risk factors such as obesity and aging. Diagnostic tools have evolved from clinical assessment to imaging modalities such as ultrasound, CT, MRI, and elastography. Conservative management, especially core stabilization, improves function in mild cases. Severe DRA may require surgical repair, including open, laparoscopic, or robotic-assisted techniques, often with mesh reinforcement. Rehabilitation and biomaterials enhance surgical outcomes. However, consensus is lacking on treatment indications and long-term efficacy. CONCLUSION: Advances in diagnostics, surgical techniques, and rehabilitation have improved DRA management. Future efforts should focus on standardizing treatment criteria, enhancing personalized care, and evaluating long-term outcomes.