POSTERIOR INTRAVAGINAL SLINGPLASTY FOR VAGINAL PROLAPSE: 7 YEARS FOLLOW-UP

Objectives: To evaluate the efficacy of the posterior intravaginal
slingoplasty (IVS) for the treatment of vaginal prolapse.
Materials: 44 patients who had undergone posterior IVS procedures
were analyzed. The median age of the patients was 61 years (range
44–77). The median parity was 3 (range 1–4).
Methods: We inserted a mesh (polypropylene) in the rectovaginal
space, from the posterior IVS tape posterior to the vaginal vault (to which it was fixed) right down to the perineal body (to which
it was also fixed). The patients were followed-up at 6 weeks, 6
months, and at yearly intervals. At each visit, a follow-up data
form was completed, and were entered into the database. At the
clinical examination, the Baden-Walker grading system for prolapse
was used. We only used grades 3 and 4 for describing significant
recurrent prolapse.
Results: There were neither complications intraoperatively nor
postoperatively. All patients were followed for 7 years. Recurrent
prolapse, grade 3 and 4, developed in 2 patients (5.88%), one
cystocele and one rectocele. The success rate of the posterior IVS
procedure for the treatment of the prolapse was 94.12%. Only one
patient had an extrusion that was definitively cured by topical
estrogen therapy and antibiotics.
Conclusions: In a long-term follow-up the posterior IVS delivered
satisfactory results for vault and posterior compartment prolapse.