title: The Posterior Intravaginal Slingplasty treatment for apical prolapse: 3 years experience in a single centre setting.
abstract: OBJECTIVE
  To assess the anatomic effectiveness and complications of the Posterior IVS technique for the treatment of pelvic organ prolapse over a period of 3 years.
  
  
  METHODS
  A retrospective, single-arm, non-comparative study involving routine, standardised, pre-operative assessment, surgery and follow-up care using the Pelvic Organ Prolapse Quantifications score at 1, 2 and 3 years was performed. The Posterior IVS technique was performed in patients with a symptomatic grade 2 or greater prolapse of the apical compartment (i.e. point C and/or D ≥ -1). Concomitant prolapse procedures were allowed.
  
  
  RESULTS
  Twenty-nine consecutive patients underwent a Posterior IVS suspension over a period of 2 years. Ninety -percent (26/29) of patients required a concomitant prolapse procedure (79% an anterior and 55% a posterior vaginal wall repair). No serious peroperative complications, bladder injuries or rectal perforations were encountered. Overall anatomical success rates (<Stage 2, International Continence Society criteria) declined from 86% to 58% and 50% after 1, 2 and 3 years, respectively. In 14% (4/29) of patients the site of anatomic recurrence was located in the apical compartment, in 31% (9/29) at the level of the anterior compartment and 14% (4/29) at the level of the posterior vaginal wall. Erosion of the Posterior IVS tape was encountered in 14% (4/29) of patients; 2 of which presented as gluteo-vaginal fistula's.
  
  
  CONCLUSIONS
  Three years follow-up of the Posterior IVS yields a high anatomical failure and substantial surgical -reintervention rate.
authors.affiliation: Ziekenhuis Oost Limburg, Schiepse Bos 6, 3600 Genk, Belgium, piet.hinoul@skynet.be.
authors.forename: P
authors.initials: P
authors.lastname: Hinoul
authors.affiliation: A.Z. Turnhout, Steenweg op Merksplas 44, 2300 Turnhout, Ruben.Vanspauwen@azstjozef-turnhout.be.
authors.forename: R
authors.initials: R
authors.lastname: Vanspauwen
authors.affiliation: Clinique Ste Anne-St Rémi, Bd Graindor 66, 1070 Brussels, Belgium, dr.smajda@skynet.be.
authors.forename: S
authors.initials: S
authors.lastname: Smajda
authors.affiliation: Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands, j.p.roovers@amc.uva.nl.
authors.forename: J-P
authors.initials: JP
authors.lastname: Roovers
keywords: Pelvic organ prolapse; Posterior IVS; apical prolapse; infraccocygeal sacropexy; mesh; surgery