Posterior intravaginal slingplasty: efficacy and complications in a continuous series of 118 cases

Cosma, Stefano; Preti, Mario; Mitidieri, Marco; Petruzzelli, Paolo; Possavino, Federica; Menato, Guido

doi:10.1007/s00192-010-1350-7

Cited by 15 publications

(14 citation statements)

References 27 publications

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“…However, previous studies demonstrated that correction of the posterior compartment with mesh increased cystocele incidence 19, 20 . Similarly, concomitant sacrospinous ligament fixations or posterior transvaginal mesh kits may increase the incidence of cystocele, or at least not decrease it.…”

Section: Discussionmentioning

confidence: 90%

Surgical proficiency decreases the rate of healing abnormalities using anterior transobturator mesh in cystocele women

Yuk

Kim

et al. 2016

F1000Res

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Aims: The objective of this study is to report the outcomes of cystocele repair with anterior transobutrator mesh kits. Methods: 119 consecutive women with cystoceles were treated between January 2006 and November 2010 by a single surgeon at a university hospital using the anterior transobturator mesh kit procedure. Postoperative follow-up visits were scheduled at 1, 6, and 12 months after surgery. Results: A total of 114 women who were operated on with the anterior transobturator mesh kit completed 12 months of follow-up. The population had a mean age of 65.8 ± 7.0, a body mass index of 25.1 ± 3.0, and a parity average of 4.0 ± 1.7. An overall anatomic cure was reported for 108 patients (94.7%). The Ba point of the POP-Q exam used for grading cystoceles decreased significantly from 2.5 ± 1.6 cm to -2.8 ± 0.8 cm after 12 months (P < 0.01). One patient (0.9%) presented with bladder perforation, and five patients (4.4%) showed with healing abnormalities. Surgical case volume was negatively correlated with healing abnormalities after adjusting for age, body mass index, operation time, and parity (P = 0.15). Conclusion: The surgeon’s experience decreases the incidence of healing abnormalities using anterior transobturator mesh in cystocele women. The anatomical cure rate of anterior transobturator mesh is quite good.

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Section: Discussionmentioning

confidence: 90%

Surgical proficiency decreases the rate of healing abnormalities using anterior transobturator mesh in cystocele women

Yuk

Kim

et al. 2016

F1000Res

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“…The rate of de novo cystocele ranges from 5.8% to 21.3% after construction of apical support (28). Cystocele reportedly develops because of a shift in intra-abdominal pressure from the reinforced posterior compartment to the anterior compartment (29). Simultaneous reinforcement of the anterior compartment or total repair of the prolapse may reduce the development of de novo defects.…”

Section: Discussionmentioning

confidence: 99%

Bilateral sacrospinous fixation without hysterectomy: 18-month follow-up

Şentürk¹,

Güraslan²,

Çakmak³

et al. 2015

J Turkish German Gynecol Assoc

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Objective:The aim of this study was to evaluate the results of bilateral sacrospinous fixation (SSF), which was performed with surgical mesh interposition and bilateral vaginal repair. Twenty-two patients underwent SSF between 2010 and, and the results were evaluated retrospectively. The results at preoperative and postoperative 6 th , 12 th , and 18 th months of the pelvic organ prolapse quantification system (POP-Q) and the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire-12 (PISQ-12) were compared using Friedman and Wilcoxon Signed Ranks tests. Values of p<0.05 and <0.01 were considered statistically significant. Material and Methods: Results:According to the POP-Q, significant healing was observed on all vaginal vault points (p=0.001), and no prolapse was observed until the 18-month follow-up stage. There were also prominent patients who felt satisfactory with respect to their sexual life according to . Conclusion:This technique appears to provide an adequate clinical resolution, and it may be the primary surgical option for women with pelvic organ prolapse. (J Turk Ger Gynecol Assoc 2015; 16: 102-6) Keywords: Pelvic organ prolapse, surgical mesh, vaginal vault Received: 29 December, 2014 Accepted: 08 March, 2015 Bilateral sacrospinous fixation without hysterectomy: 18-month follow-up Abstract(PISQ-12) forms were completed. In addition, all patients were evaluated with Pap smear, and transvaginal ultrasonography was performed to evaluate endometrial thickness in postmenopausal patients. The operation time and the intraoperative and postoperative complications were recorded. All patients were re-examined according to the POP-Q system, and PISQ-12 forms were completed at 6, 12, and 18 months postoperatively (12). Treatment failure was defined as the presence of more than stage 1 prolapse. All surgeries were conducted under spinal anesthesia by a single surgeon experienced in pelvic floor surgery. Foley catheter was removed 6h after surgery. Postvoiding residual volume was evaluated by the Foley catheter, and PVR of less than 50 ml is considered to constitute adequate bladder emptying (13). Postvoidal residual volume was evaluated only in patients with stress urinary incontinence. All patients were discharged from the hospital on postoperative day 2. There was no necessary approval of the local ethic community because of the retrospective design of the study.The procedure was initiated with saline infusion from the posterior vaginal wall towards the ischial spine under the mucosa. After the initial midline incision was made on the posterior vaginal wall, digital blunt dissection of the coccygeus muscle was performed to access the sacrospinous ligament. The adipose tissue overlying the coccygeus muscle was removed to completely expose the sacrospinous ligament. A polypropylene suture (Prolen®; Ethicon, Norderstedt, Germany) (no:1) was bilaterally placed on the sacrospinous ligament. The tips of the 5×1.5 cm polypropylene mesh (Prolen®; Ethicon, Norderstedt, Germany) were suspended over th...

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“…It uses a type III multifilament polypropylene tension-free tape to create an artificial uterosacral neoligament thus anchoring the apex of the prolapsed vaginal vault 1. Cure rates show wide variation, being reported to be between 71% and 91% 2–4. Likewise complication rates show great variability.…”

Section: Discussionmentioning

confidence: 99%

“…Likewise complication rates show great variability. In the most recent and comprehensive review of the literature,4 common complications included vaginal and rectal erosions (8.5%), apical recurrence (6.1%), posterior recurrence (4.6%), de novo stripsis (5.3%), dyspareunia (5.2%), buttock pain (3.3%) and haematoma formation (2.6%). Rarer complications include rectal injury (0.8%) and ‘abscess and fistula’ formation (1.4%).…”

Section: Discussionmentioning

confidence: 99%

Gluteo-vaginal fistula: a long-term complication of posterior intravaginal slingplasty

Sivarajah

Bello²,

Yiu³

et al. 2011

Case Reports

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A 67-year-old lady presented to the surgical outpatient clinic with a 4 month history of recurrent purulent discharge from her left buttock. Four years and 4 months prior to this she underwent a posterior intravaginal slingoplasty for vaginal prolapse and urinary stress incontinence. An MRI demonstrated a long gluteo-vaginal fi stula tract from the posterior wall of the vaginal vault through the left ischiorectal fossa to the skin. An examination under anaesthesia revealed that the fi stulous tract was surrounding the intact mesh used for the posterior intravaginal slingoplasty. The mesh was removed, the fi stula tract excised and the perineal wound marsupialised. The patient was discharged 5 days later. The wound healed within 4 weeks and she remains sepsis free 2 years on.

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Posterior intravaginal slingplasty: efficacy and complications in a continuous series of 118 cases

Abstract: PIVS seems a safe and effective procedure for VCP and UVP. Vaginal erosion was mainly observed in patients with VCP treated with multifilament polypropylene mesh.

Cited by 15 publications

References 27 publications

Surgical proficiency decreases the rate of healing abnormalities using anterior transobturator mesh in cystocele women

Surgical proficiency decreases the rate of healing abnormalities using anterior transobturator mesh in cystocele women

Bilateral sacrospinous fixation without hysterectomy: 18-month follow-up

Gluteo-vaginal fistula: a long-term complication of posterior intravaginal slingplasty

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