ABSTRACT

The safety, efficacy and patient satisfaction of the intra vaginal posterior sling procedure (PIVS) for correction of vaginal vault prolapse or descensus uteri was estimated in 3 Dutch hospitals. A population of 150 patients underwent a PIVS between January 2002 and April 2005 was evaluated retrospectively. Between 4 and 18 months after the operation an inquiry was sent to all to evaluate the results after this middle-long follow-up period. In 87% (131/150) PIVS was combined with other surgical techniques as vaginal hysterectomy, anterior and/or posterior vaginal wall repair. No complications occurred during surgery. Complications post operatively were: cystitis 13, fever 1, hematoma 8. After 8 weeks there was no improvement of prolapse complaints in 16 patients (11%). In 19 (13%) a secondary prolapse was found, mainly cystocele (14 patients). Of the 100 patients with micturition or urinary incontinence problems before the operation, 70 experienced improvement of their presenting complaints. De novo urgency was found in 12 patients (8%). Tape erosion occurred in 4 patients (2.6%) during the follow-up period. Response rate of the questionnaire was 65%. The mean score for patient satisfaction was 4.8 (range 0-5) and the mean score for efficacy 4.6 (range 0-5). PIVS is a safe and effective treatment for vaginal vault prolapse or descensus uteri, with a high score for patient satisfaction during a medium follow-up.