Morbidity associated with posterior intravaginal slingplasty for uterovaginal and vault prolapse

被引：24

作者：

Hefni M. ^{[1
]}

Yousri N. ^{[1
]}

El-Toukhy T. ^{[1
,2
]}

Koutromanis P. ^{[1
]}

Mossa M. ^{[1
]}

Davies A. ^{[1
]}

机构：

[1] Department of Gynaecology, Benenden Hospital, Cranbrook, Kent

[2] Assisted Conception Unit, Guy's Hospital, Thomas Guy House

来源：

Archives of Gynecology and Obstetrics | 2007年 / 276卷 / 5期

关键词：

Outcome; Posterior IVS; Uterovaginal prolapse; Vault prolapse;

D O I：

10.1007/s00404-007-0375-8

中图分类号：

学科分类号：

摘要：

Objective: This study was carried out to evaluate the safety and efficacy of posterior intravaginal slingplasty (IVS) for upper genital prolapse. Setting: Gynaecology Department, Benenden Hospital, Kent, UK. Materials and methods: An observational study was conducted on 127 women, who underwent posterior IVS using the IVS Tunneller (Tyco HealthCare, USS, Norwalk, CT, USA). The indications for surgery were uterovaginal prolapse in 65% and vault prolapse in 35%. Patient follow-up was at 6 weeks, 6 months, 1 year and annually thereafter. Results: In addition to posterior IVS, hysterectomy was performed in 22 patients, anterior colporrhaphy in 63 patients and transobturator mid-urethral tape insertion in eight patients. The mean operating time was 46 ± 18.5 min and for posterior IVS alone was 27.4 ± 10 min, and the mean peri-operative drop in haemoglobin level was 1.4 ± 0.75 gm/dL. There were no rectal, vesical or ureteric injuries. After a mean follow-up of 14 months (range 2-26 months), upper genital support was maintained in 88%, cystocele formation occurred in 8% and recurrent rectocele was seen in 11%. There was a 17% risk of tape erosion (21/127) and a re-operation rate of 24% (30/127). The risk of tape erosion was related to patient age above 60 years (RR = 1.6, 95% CI 1.02-2.5) and current treatment for diabetes (RR = 4, 95% CI 1.7-9.2). Parity, body mass index, menopausal status, HRT use, hysterectomy and surgeon's experience were not found to influence tape erosion rate. Conclusion: Posterior intravaginal slingplasty is a minimally invasive procedure for upper genital prolapse with an acceptable success rate. However, the operation is associated with high vaginal erosion and re-operation rates. © 2007 Springer-Verlag.

引用

页码：499 / 504

页数：5

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