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Original article Kim M. Haest (*) - Tom H. Hasaart (*) - Ilknur Sanli (*) - Ed T. Gondrie (**) Martin G. Bergmans (***)

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



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Table 2: Operations performed in the study group in combination with PIVS*.

PIVS alone

19

with colporraphy anterior

21

with colporraphy posterior

59

with colporraphy anterior and posterior

36

with vaginal hysterectomy

14

with IVS anterior

1

total

150

* PIVS = posterior intravaginal sling



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Table 3: Influence of surgical treatment on pelvic floor disorders.

Influence of prolapse surgery

Pre Op

Post Op

 

 

Complete Cure

Improved

Unchanged

Worse

Prolapse sensation

83

0

77

3

3

Micturition problems/incontinence

57

26

5

7

19

Defaecation problems

35

22

0

13

0

Dyspareunia

24

6

6

6

6


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Table 4: Complications of surgical treatment of prolapse using PIVS.

Literature

Cases

Surgical complications

Fever

Hematoma

Cystitis

Tape erosion

Biertho et al.

34

0

-

0

-

1

Everhardt et al.

32

0

-

-

-

8

Farnsworth

93

2

0

0

5

1

Haest et al.

150

0

1

8

13

4

Meschia et al.

33

0

-

-

-

1

Petros

75

2

0

0

-

4


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(*) 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