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
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 ::
Harefuah. 2007 Jan ;146