Paper Presentations: AUGS Abstracts: 2005 26th Annual Scientific Meeting of The American Urogynecologic Society
To evaluate our experience with the posterior vaginal sling in providing vaginal support in an elderly population.
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.)
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.
In our elderly population, the posterior vaginal sling had a high failure rate that occurred early after the procedure.