IVS posteriore, intervento chirurgico mininvasivo per la cura del prolasso vaginale: efficacia e long-term follow-up

Aim: the objective of our study was to asses the efficacy, the effectiveness and complications of the posterior intravaginal slingoplasty (IVS) for the treatment of vaginal prolapse over a period of 8 years.Methods: The posterior IVS is a minimally invasive procedure for the vaginal vault prolapse utilizing a vaginal approach. We inserted a mesh in the recto-vaginal space to the vaginal vault (to wich it was fixed) right down to the perineal body (to wich it was also fixed).44 patients who had undergone posterior IVS procedures were analyzed. The median age of the patients was 61 years (range 44-77). The median parity was 3(range 1-4). The patients were followed-up at 6 weeks, 6 months, and at yearly intervals. At each visit, a follow-up data form was completed, and were entered into the database. At the clinical examination, the Baden-Walker grading system for prolapse was used. We only used grades 3 and 4 for describing significant recurrent prolapse.Results: Neither complications intraoperatively and postoperatively occurred, nor rectal perforatios or bladder injuries. The success rate for these procedure was 94.12%. All patients were followed for 8 years. Recurrent prolapse, grade 3 and 4, developed in 2 patients (5.88%), one cystocele and one rectocele. Only one patient had an extrusion that was definitively cured by topical estrogen therapy and antibiotis.Conclusions: In eight years follow-up the posterior IVS delivered satisfactory results for vault and posterior compartment prolapse.