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Paper 8: Posterior Vaginal Sling Experience in Elderly Patients Yields Poor Results

Moore, S; Mattox, F

Journal of Pelvic Medicine and Surgery: 2005 - Volume 11 - Issue - p S4
doi: 10.1097/01.spv.0000176084.01957.44
Paper Presentations: AUGS Abstracts: 2005 26th Annual Scientific Meeting of The American Urogynecologic Society

Greenville Hospital System, Greenville, SC

Disclosure – Grant/Research Support: Eli Lily: F. Mattox; Speaker's Bureau: Ortho McNeil: F. Mattox; Yamanouchi: F. Mattox; Watson Pharmaceutical: F. Mattox; Indevus: F. Mattox.

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To evaluate our experience with the posterior vaginal sling in providing vaginal support in an elderly population.

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Elderly patients with significant vaginal prolapse who were unable to tolerate or declined major surgery were offered a posterior vaginal sling for vaginal support. Patients were considered failures if POPQ (Pelvic Organ Prolapse Quantitative) Point C returned within 2 cm of their preoperative value, or there was any protrusion of the anterior or posterior vaginal wall beyond the hymeneal ring (greater than 0 on any POPQ point Aa, Ba, Ap, Bp.)

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Twenty-one patients underwent the procedure. The average age was 72 years (range 60–76) with an average parity of 4 (range 2–9.) By our postoperative criteria, 9 were considered failures (9/21, 43%). There were 6 POPQ Point C failures, 1 POPQ Aa failure, and 2 POPQ Ba failures.) The time to failure ranged from 5–29 weeks (mean 12 weeks, median 8 weeks). Three of the failed patients underwent a second procedure (colpocleisis), 2 were fitted with a pessary but 1 discontinued due to bleeding, and 16 chose to live with their disease.

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In our elderly population, the posterior vaginal sling had a high failure rate that occurred early after the procedure.

© 2005 Lippincott Williams & Wilkins, Inc.