title: Risk factors for surgical failure after posterior intravaginal slingplasty: a case series.
abstract: OBJECTIVE
  The goal of this study was to analyze the potential risk factors of surgical failure after posterior intravaginal slingplasty for uterine or vaginal vault prolapse.
  
  
  METHODS
  Women 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.
  
  
  RESULTS
  The 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%).
  
  
  CONCLUSIONS
  Procidentia 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.
authors.affiliation: Department of Obstetrics and Gynecology, China Medical University Hospital, Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan. d888208@ms45.hinet.net
authors.forename: Huey-Yi
authors.initials: HY
authors.lastname: Chen
authors.forename: Ming
authors.initials: M
authors.lastname: Ho
authors.forename: Yin-Yi
authors.initials: YY
authors.lastname: Chang
authors.forename: Yao-Ching
authors.initials: YC
authors.lastname: Hung
authors.forename: Wen-Chi
authors.initials: WC
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008875:Middle Aged; D056887:Pelvic Organ Prolapse / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology; D012307:Risk Factors; D012720:Severity of Illness Index; D017211:Treatment Failure; D019687:Uterine Inversion / Q000453:epidemiology; D014596:Uterine Prolapse / Q000601:surgery*