Pelviperineology

Original article Kim M. Haest (*) - Tom H. Hasaart (*) - Ilknur Sanli (*) - Ed T. Gondrie (**) Martin G. Bergmans (***)
(*) Dept. of Obstetrics and Gynecology, Catharina Hospital, Eindhoven, The Netherlands
(**) Dept. of Obstetrics and Gynecology, Maasland Hospital, Sittard, The Netherlands
(***) Dept. of Obstetrics and Gynecology, Laurentius Hospital, Roermond, The Netherland

Intravaginal posterior sling procedure (PIVS)for the treatment of uterine descensus and vaginal vault prolapse:retrospective analysis of efficacy, safety, complications and patient satisfaction in 150 cases.

Table 1: Pre-operative assessment of cervical or vaginal vault prolapse, and combinations with anterior and posterior vaginal wall prolapse.

descensus cervix/ vaginal apex		cystocele	rectocele enterocele	cystocele recto/enterocele	no significant cysto/rectocele	total
C E R V I X	grade 1	0	1	2	0	3
	grade 2	10	19	11	0	40
	grade 3	2	1	3	0	6
	grade 4	2	0	0	15	17
vault prolapse grade 3 or 4		39	33	8	4	84

TABLE 2. – Tape used in posterior IVS procedure.

Nylon Tape	49 patients
Multifilament polypropylene tape	78 patients

TABLE 3. – Outcomes.

 

Apical failure	14 patients (11.67%)
Cystocoele	27 patients (22.5%)
Rectal trauma	2 patients (1.6 %)
Pudendal or inferior haemorrhoidal artery damage	0 patients
Nerve injury	0 patients
Ischiorectal abscess nylon tape	0 patients
Mesh extrusion nylon tape at 2 years	5 patients (10%)
Mesh extrusion nylon tape at 6 years	5 patients (10%)
Ischiorectal abscess multifilament polypropylene tape	3 patients
Mesh extrusion multifilament polypropylenetape at 2 years	2 patients (3%)
Mesh extrusion multifilament polypropylene tape at 6 years	8 patients (11%)
Clinical Infection of prosthesis	17 patients (14%)
Clinical tape rejection	9 patients (7.5%)
Post operative haematoma	5 patients (4%)
Blood transfusion	0 patients