Morbidity & Long Term Subjective Outcome of Posterior Intravaginal
Slingplasty (IVS) for Uterovaginal & Vaginal Vault Prolapse
Authors: Dr Louisa Hermis, Dr David Rae
Institution: Crosshouse Hospital, Kilmarnock.
Objectives:
To evaluate the morbidity & long term subjective outcome following posterior IVS for
women with uterovaginal or vaginal vault prolapse.
Introduction:
Posterior IVS is a minimally invasive surgical technique for the correction of vaginal
vault and uterovaginal prolapse. An 8mm polypropylene tape inserted between the
perineum & the vaginal vault creates an artificial neoligament which re-enforces the
atrophied uterosacral ligaments and resuspends the vaginal vault. To date,
preliminary published data has described short-term success and morbidity only.
This study is the first to present long-term subjective outcomes following this
procedure.
Method:
A prospective observational study of a cohort of 82 women who underwent posterior
IVS between March 2003 and March 2006. Morbidity, including intra-operative and
post-operative complications is described. A validated prolapse questionnaire (PQOL) was completed by the women pre-operatively and at a mean interval of 25.5
months post surgery.
Results:
38 women had concomitant vaginal hysterectomy and in 3 women posterior IVS was
performed with uterine conservation. Mean length of hospital stay was 4 days.
Objective success (satisfactory vaginal vault support) is 92.7%. No rectal
perforations occurred but 3 women experienced intra-operative bleeding. Tape
erosion necessitating removal of IVS tape occurred in 13.4% (11 women). Long term
subjective outcomes, utilising the P-QOL questionnaire, showed an overall marked
improvement in all the 9 domains of the P-QOL form (statistical analysis to be
completed).
Conclusion:
Posterior IVS is a safe surgical technique for the correction of vaginal vault prolapse
with a similar efficacy to other surgical techniques. Although the long term outcome
with respect to vault support and patient satisfaction seems favourable, the
incidence of vaginal tape erosion seems high.