Risk factors for surgical failure after posterior intravaginal slingplasty: a case series |
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Authors: | Chen Huey-Yi Ho Ming Chang Yin-Yi Hung Yao-Ching Chen Wen-Chi |
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Institution: | a Department of Obstetrics and Gynecology, China Medical University Hospital, Graduate Institute of Integrated Medicine, China Medical University, No. 2 Yu-Der Road, Taichung 404, Taiwan b Department of Obstetrics and Gynecology, China Medical University Hospital, School of Medicine, China Medical University, Taichung, Taiwan c Department of Urology, China Medical University Hospital, Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan |
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Abstract: | ObjectiveThe goal of this study was to analyze the potential risk factors of surgical failure after posterior intravaginal slingplasty for uterine or vaginal vault prolapse.Study designWomen with symptomatic uterine or vaginal vault prolapse that extended to or beyond the introitus were eligible for inclusion. Each woman underwent a detailed history taking and a vaginal examination for staging of pelvic organ prolapse before treatment. Follow-up evaluations were at 3, 6, 9, 12, 18, 24, and 30 months after the operation. Surgical failure is defined as the presence of symptomatic uterine or vaginal vault prolapse ≧stage 2 (higher than 0, at the hymen) after posterior intravaginal slingplasty.ResultsThe surgical failure rate (8/61) following posterior intravaginal slingplasty was 13.1%. Using univariable logistic regression, C or D point stage IV before surgery was significantly associated with surgical failure of posterior intravaginal slingplasty for uterine or vaginal vault prolapse. Complications (11/61 = 18%) included vaginal erosion (9.8%), blood loss over 500 ml (4.9%), and perineal pain (3.3%).ConclusionProcidentia is a significant risk factor for surgical failure of posterior intravaginal slingplasty, and therefore this procedure should never be used alone in patients with complete uterine or vaginal vault prolapse. |
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Keywords: | Posterior intravaginal slingplasty Uterine prolapse Vaginal vault prolapse Procidentia Uterosacral ligament |
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