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

Authors

  • Giampiero Capobianco,

    Corresponding author
    1. Department of Surgical, Microsurgical and Medical Sciences, Gynecologic and Obstetric Clinic, University of Sassari, Sassari, Italy
    • Reprint request to: Dr Giampiero Capobianco, Gynecologic and Obstetric Clinic, Department of Surgical, Microsurgical and Medical Sciences, University of Sassari, Viale San Pietro 12, 07100 Sassari, Italy. Email: capobia@uniss.it

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  • Ermes Donolo,

    1. Department of Surgical, Microsurgical and Medical Sciences, Gynecologic and Obstetric Clinic, University of Sassari, Sassari, Italy
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  • Jean Marie Wenger,

    1. Gynecologic and Obstetric Clinic, University of Geneva, Geneva, Switzerland
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  • Massimo Madonia,

    1. Department of Surgical, Microsurgical and Medical Sciences, Institute of Urology, University of Sassari, Sassari, Italy
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  • Erich Cosmi,

    1. Gynecologic and Obstetric Clinic, University of Padua, Padua, Italy
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  • Lavinia Antimi,

    1. Department of Surgical, Microsurgical and Medical Sciences, Gynecologic and Obstetric Clinic, University of Sassari, Sassari, Italy
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  • Margherita Dessole,

    1. Department of Surgical, Microsurgical and Medical Sciences, Gynecologic and Obstetric Clinic, University of Sassari, Sassari, Italy
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  • Pier Luigi Cherchi

    1. Department of Surgical, Microsurgical and Medical Sciences, Gynecologic and Obstetric Clinic, University of Sassari, Sassari, Italy
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Abstract

Aim

The aim of this study was to assess the long-term efficacy and complication rates of posterior intravaginal slingplasty (IVS) in women suffering from genital prolapse.

Material and Methods

Posterior IVS or infracoccygeal sacropexy is a minimally invasive procedure for suspension of the vagina with the goal of creating new uterosacral ligaments through the insertion of a polypropylene tape. Forty-four patients were enrolled: 25 patients, affected by uterovaginal prolapse, were subjected to vaginal hysterectomy and posterior IVS; and 19 patients, diagnosed with vaginal vault prolapse, were subjected to posterior IVS alone. The primary outcome for posterior IVS was 12-month, 24-month and annual 9-year postoperative efficacy that is based on a Pelvic Organ Prolapse Quantitative score of −5 at point C, which describes the vaginal apex.

Results

Of the 44 patients who underwent posterior IVS, none required blood transfusions with an average reduction of perioperative hemoglobin of 1.2 ± 0.4 g/dl, and the average time of hospitalization was 4.3 ± 0.6 days. The rate of success was 93.18% (41/44) at 9 years' follow-up. We had only one case of extrusion (2.27%) and three cases of recurrence (6.82%), such as two cases of cystocele and of rectocele.

Conclusions

Most patients interviewed confirmed that their quality of life improved after surgery, 86.36% of the operated patients reported that their sexual performance improved and that they would recommend this surgery for their friends. Posterior IVS was a minimally invasive surgical procedure with a high success rate for genital prolapse.

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