The Posterior Intravaginal Slingplasty treatment for apical prolapse: 3 years experience in a single centre setting
Pelvic organ prolapse, apical prolapse, surgery, mesh, Posterior IVS, infraccocygeal sacropexy
Published online: Jun 03 2009
Aim: To assess the anatomic effectiveness and complications of the Posterior IVS technique for the treatment of pelvic organ prolapse over a period of 3 years.
Methods:A retrospective, single-arm, non-comparative study involving routine, standardised, pre-operative assessment,surgery and follow-up care using the Pelvic Organ Prolapse Quantifications score at 1, 2 and 3 years was performed.The Posterior IVS technique was performed in patients with a symptomatic grade 2 or greater prolapse of the apicalcompartment (i.e. point C and/or D -1). Concomitant prolapse procedures were allowed.
Results: Twenty-nine consecutive patients underwent a Posterior IVS suspension over a period of 2 years. Ninetypercent (26/29) of patients required a concomitant prolapse procedure (79% an anterior and 55% a posterior vaginalwall repair). No serious peroperative complications, bladder injuries or rectal perforations were encountered. Overall anatomicalsuccess rates (<Stage 2, International Continence Society criteria) declined from 86% to 58% and 50% after 1, 2 and3 years, respectively. In 14% (4/29) of patients the site of anatomic recurrence was located in the apical compartment,in 31% (9/29) at the level of the anterior compartment and 14% (4/29) at the level of the posterior vaginal wall. Erosionof the Posterior IVS tape was encountered in 14% (4/29) of patients; 2 of which presented as gluteo-vaginal fistula’s.
Conclusion: Three years follow-up of the Posterior IVS yields a high anatomical failure and substantial surgicalreintervention rate.Key words: Pelvic organ prolapse, apical prolapse, surgery, mesh, Posterior IVS, infraccocygeal sacropexy.