Mesh Implants - PIVS

Posterior intra-vaginal sling (PIVS) for vaginal vault prolapse after hysterectomy: preliminary results of the first 80 operations with a novel procedure

Yuval Lavy, Menahem Neuman, Achinoam Lev-Sagi, Shlomo Shimonowitz, Michal Luria, Jacob Borenstein Urogynecology, Department of Gynecology, Hadassah Medical Center Mount Scopus, Hebrew University of Jerusalem.


BACKGROUND: One of the most significant challenges in surgical gynecology during the last decade was the treatment of vaginal vault prolapse after hysterectomy. Difficult extensive procedures have been advocated for this purpose. The posterior intra-vaginal slingplasty (PIVS) has recently been introduced. This procedure is based on the integral theory of pelvic floor stability and the use of mesh implants to achieve more reliable tissue stability than attaching the prolapsed tissue to the pelvic bones and ligaments.


AIM: To evaluate the therapeutic outcome, safety and complications of the PIVS procedure.


METHODS: A total of 80 post hysterectomy patients with vagina vault prolapse underwent PIVS operation within one year.


RESULTS: All patients but one expressed satisfaction with the 12 months therapeutic results. The PIVS procedure does not require either laparotomy or deep trans-vaginal dissection.


CONCLUSIONS: The PIVS was shown to be safe, effective and minimally invasive, and is therefore recommended as another treatment option for women with post hysterectomy vaginal vault prolapse. Mesh-terms: Aged; Aged, 80 and over; Female; Humans; Hysterectomy :: adverse effects; Middle Aged; Suburethral Slings; Uterine Prolapse :: prevention & control; Uterine Prolapse :: surgery;


Source: Harefuah. 2007 Jan ;146 (1):4-6, 80


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