Posterior intravaginal slingplasty (infracoccygeal sacropexy) in the treatment of vaginal vault prolapse

Abstract

Historically, posthysterectomy vaginal vault prolapse has been treated vaginally (sacrospinous fixation), abdominally (sacrocolpopexy), or by combined abdominopelvic procedures. Recently, interest has focused on less invasive laparoscopic approaches, but they require a high degree of skill. In 1997, Petros [1] proposed the infracoccygeal sacropexy (posterior intravaginal slingplasty) as an outpatient procedure based on the integral theory that he advocated. This report presents the results obtained with intravaginal slingplasty at the Vali-e-Between 2003 and 2004 a prospective study of the posterior IVS procedure was performed with 15 women. All patients had had clinical evidence of vault prolapse following hysterectomy (grades 3 and 4 with the pelvic organ prolapse quantification [POP-Q] system). Intraoperative and postoperative complications and associated symptoms such as urgency to urinate, nocturia, and pelvic pain were recorded using a previously validated questionnaire. Patients were followed up 1, 3, 6, and 18 months postoperatively.All procedures were performed by the same surgeon and polypropylene tape (Tyco Health care, USA) was used in all patients. The mean age of patients was 67 years (50-81 years) and operative time was 30 min (20-40 min). Mean intraoperative blood loss was less than 130 mL. All patients were discharged within 24 h of surgery.To assess results the patients answered a questionnaire and were requested to strain while being examined in a semi-recumbent position. When the 0020-7292/$ -see front matter D

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

“…Posterior IVS proved to be an effective, minimally invasive treatment for prolapse of the vaginal vault. Our study confirmed what has already been reported in the extensive international literature about the high success rate of this procedure, which also improves the symptoms that usually are associated with genital prolapse: nocturia, incontinence and pelvic pain . It is a minimally invasive procedure that takes little time to perform, does not require extensive dissection of the pararectal space, and has a low risk of intraoperative complications …”

Vaginal surgery for uterine descent; which options do we have? A review of the literature

“…In none of the studies were complications separately described for the subgroup of women in which the uterus was preserved. Therefore, for describing complications, we used data for women who underwent a posterior intravaginal slingplasty with and without preservation of the uterus [37][38][39][40][41][42][43][44][45][46][47].…”

“…Therefore, after cervical amputation, a risk of stenosis is present, which could influence the occurrence of alarming symptoms (vaginal blood loss) in the development of adenocarcinoma of the uterus. After a posterior intravaginal slingplasty (with and without preservation of the uterus) mesh erosion problems were reported in 0% to 21% of women [37][38][39][40][41][42][43][44][45][46][47]. Baessler et al described erosion problems in 13 women who were referred to their clinic after implantation of a multifilament mesh at other clinics [56].…”

“…An illustration that [4,5,7,17,21,27,28,30,32,33] c References [18][19][20]34] d References [37][38][39][40][41][42][43][44][45][46][47] symptoms are not always associated with anatomical outcome is the recent study on the sacrospinous hysteropexy by Dietz et al in which women with and without a cystocele stage 2 or more described the same amount of bother on urogynecological symptoms [33]. For measuring these functional outcomes the use of validated disease-specific symptom and quality of life questionnaires is highly recommended [58].…”

Infracoccygeal sacropexy for uterovaginal prolapse

“…Farnsworth [11] reported a 91% success rate with 93 patients (there was 1 case of rectal extrusion of the sling), with no postoperative pain. Ghanbari et al [15] provided no data concerning postoperative pain. The rate of postoperative pain was lower in these studies of infracoccygeal sacropexy than in the present study, in which it was calculated for a mean follow-up duration of 27 months.…”