[A new minimally invasive procedure for the conservative treatment of uterine prolapse--the posterior IVS].
BACKGROUND
The risk of women who undergo surgery for the treatment of pelvic organ prolapse (POP) by the age of 80 is reported to exceed 10%, and is expected to rise with the increase in life expectancy. Most women affected are in their 5th or 6th decade, and the majority will suffer other medical problems. The current medical literature asserts that the vaginal surgical approach for POP operations are followed by less complications and provide a shorter rehabilitation period than the abdominal route. Hysterectomy is widely accepted as part of POP reconstructive surgery whenever the uterus is significantly prolapsed, however, there is no clear evidence to support the role of hysterectomy in improving surgery outcome. We present our experience with a new minimally invasive procedure - the posterior intravaginal slingplasty (IVS) for utero-suspension in the presence of moderate and advanced uterine prolapse.


OBJECTIVE
To evaluate the feasibility, intra- and post-operative complications and short term results of the posterior IVS procedure and uterosuspension for uterine prolapse.


METHODS
Reconstructive surgery using the posterior IVS was performed on 18 women with moderate to severe uterine prolapse who chose to preserve their uterus. Patients were then followed 1,6,12 months and 2 years post-operatively to assess any recurrence of pelvic organ prolapse.


RESULTS
No major intra- or post-operative complications were reported. Follow-up of one to 13 months showed good results.


CONCLUSIONS
Reconstructive POP surgery may not necessitate hysterectomy. The posterior IVS is a novel safe, minimally invasive, simple and effective surgical procedure for the treatment of POP, permitting uterine preservation. A larger number of patients and a longer follow-up period are required for proper evaluation of the actual safety and efficacy of this procedure.
Lavy
Y
Y
Department of Gynecology, Hadassah Mt. Scopus. lavyl@hadassah.org.il
Lev-Sagi
A
A
Arbell
R
R
Shimonowitz
S
S
Neuman
M
M
D005260:Female; D013509:Gynecologic Surgical Procedures; D006801:Humans; D019060:Minimally Invasive Surgical Procedures; D019651:Plastic Surgery Procedures; D016896:Treatment Outcome; D014596:Uterine Prolapse / Q000601:surgery*