Efficacy and 9 years' follow-up of posterior intravaginal slingplasty for genital prolapse

J Obstet Gynaecol Res. 2014 Jan;40(1):219-23. doi: 10.1111/jog.12162. Epub 2013 Sep 19.

Abstract

Aim: The aim of this study was to assess the long-term efficacy and complication rates of posterior intravaginal slingplasty (IVS) in women suffering from genital prolapse.

Material and methods: Posterior IVS or infracoccygeal sacropexy is a minimally invasive procedure for suspension of the vagina with the goal of creating new uterosacral ligaments through the insertion of a polypropylene tape. Forty-four patients were enrolled: 25 patients, affected by uterovaginal prolapse, were subjected to vaginal hysterectomy and posterior IVS; and 19 patients, diagnosed with vaginal vault prolapse, were subjected to posterior IVS alone. The primary outcome for posterior IVS was 12-month, 24-month and annual 9-year postoperative efficacy that is based on a Pelvic Organ Prolapse Quantitative score of -5 at point C, which describes the vaginal apex.

Results: Of the 44 patients who underwent posterior IVS, none required blood transfusions with an average reduction of perioperative hemoglobin of 1.2 ± 0.4 g/dl, and the average time of hospitalization was 4.3 ± 0.6 days. The rate of success was 93.18% (41/44) at 9 years' follow-up. We had only one case of extrusion (2.27%) and three cases of recurrence (6.82%), such as two cases of cystocele and of rectocele.

Conclusions: Most patients interviewed confirmed that their quality of life improved after surgery, 86.36% of the operated patients reported that their sexual performance improved and that they would recommend this surgery for their friends. Posterior IVS was a minimally invasive surgical procedure with a high success rate for genital prolapse.

Keywords: follow-up; genital prolapse; posterior intravaginal slingplasty.

MeSH terms

  • Aged
  • Female
  • Follow-Up Studies
  • Hospitals, University
  • Humans
  • Italy
  • Mediterranean Islands
  • Middle Aged
  • Minimally Invasive Surgical Procedures / adverse effects
  • Pelvic Organ Prolapse / physiopathology
  • Pelvic Organ Prolapse / surgery*
  • Postoperative Complications / prevention & control*
  • Quality of Life*
  • Sexual Behavior
  • Sexual Dysfunction, Physiological / etiology
  • Sexual Dysfunction, Physiological / prevention & control
  • Sexual Dysfunctions, Psychological / etiology
  • Sexual Dysfunctions, Psychological / prevention & control
  • Uterine Prolapse / physiopathology
  • Uterine Prolapse / surgery