Mid-term Results and Complications of Posterior Intravaginal Slingplasty for Patients with Uterine and Vaginal Vault Prolapse / 대한비뇨기과학회지

ABSTRACT

PURPOSE: Only a few reports have been published describing the mid-term results of posterior intravaginal slingplasty(IVS). We analyzed the efficacy and complications of this procedure. MATERIALS AND METHODS: We analyzed the treatment outcomes of 95 patients who underwent posterior IVS due to uterine(n=59) and vaginal vault(n=36) prolapse. The degrees of prolapse were classified according to pelvic organ prolapse quantification(POPQ) of the International Continence Society(ICS), and posterior IVS was conducted for cases above stage 2. Polypropylene tape was used for all 95 patients. On the postoperative evaluation, stage 0 was regarded as a complete remission, stage 1 as an improvement and above stage 2 as a failure. RESULTS: Among the patients operated on for uterine and vaginal vault prolapse, 48(81.4%) and 30(83.3%) patients were cured, and 8(13.6%) and 6(16.7%) patientsshowed improvement, and 3(5.1%) and 0(0%) patients showed failure, respectively. The mean hospitalization was 3.3 and 3.8 days, the mean operative time was 37.4 and 36.7 minutes, and the mean bleeding volume was 91 and 102ml in the uterine prolapse group and the vaginal vault prolapse group, respectively. The mean follow-up time was 27.3 months(2-40). Identified complications were tape erosion in 9 cases(9.5%), hemorrhage that needed transfusion in 3 cases(3.2%), and recurrent prolapse in 3 cases(3.2%). CONCLUSIONS: Posterior IVS proved to be a highly effective therapeutic method for uterine and vaginal vault prolapse, with a low surgical risk and less discomfort to the patients. Tape erosion was a relative frequent complication of this operation.