Posterior vaginal sling experience in elderly patients yields poor results.
OBJECTIVE
The objective of the study was to evaluate our experience with the posterior vaginal sling in an elderly population.


METHODS
Elderly patients with significant vaginal prolapse underwent a posterior vaginal sling using the IVS Tunneller device (Tyco Healthcare, United States Surgical, Norwalk, CT). Primary failure was defined as a postoperative pelvic organ prolapse quantitative point C (the apex of the vagina) within 2 cm of the preoperative value. Secondary failure was defined as any portion of the anterior or posterior vaginal walls protruding to or beyond the hymeneal ring (pelvic organ prolapse quantitative points Aa or Ap equal to or greater than 0).


RESULTS
Twenty-one patients underwent the procedure; 19 were seen for follow up. The average age was 70 years (range 60-78). Twelve patients had primary or secondary failures (12 of 19, 63%). There were 5 primary failures (5 of 19, 26%) and 7 secondary failures (7 of 19, 37%). The mean time to failure was 7 weeks (range 1-18).


CONCLUSIONS
In our elderly population, the posterior vaginal sling has a high failure rate, occurring early in the postoperative period.
Center for Women's Medicine, Greenville Hospital System, Greenville, SC, USA. tfmattox@ghs.org
T Fleming
TF
Mattox
Susan
S
Moore
Edward J
EJ
Stanford
Benjie B
BB
Mills
D000368:Aged; D005260:Female; D013509:Gynecologic Surgical Procedures; D006801:Humans; D008875:Middle Aged; D017211:Treatment Failure; D014596:Uterine Prolapse / Q000601:surgery*