Comparative Evaluation of Short-Term Results of Posterior Intravaginal Sling Procedure and Sacrospinous Fixation in Surgical Management of Apical Defects in Pelvic Organ Prolapse

Objective: In the success of surgical treatment of POP; it is important to relieve symptoms, correction of anatomy, to increase sexual and visseral functions. PIVS, a new operation method started to be applied for POP apical defects and conventional SSLF operations? short term results, complications and effects on life quality are compared our study.Materials and Methods: This study was conducted between September 2007 and October 2008 over 40 patients admitted to our clinic with diagnosis of symptomatic uterovaginal or vaginal cuff prolapsus (Phase II or more). SSLF and/or additional operations to 20 patients and PIVS and/or additional operations to the other 20 patients were applied and hysterectomy, anterior repair, posterior repair and operations for stress incontinence addition to these operations were performed if required. Questionnaire forms (PISQ?12, PFIQ?7, PFDI?20, PSI-QQL forms) evaluating demographic characters, history, quality of life and symptoms were filled. During physical examination pelvic organ prolapsus was evaluated according to POPQ scoring system. Type and time of the operation, intraoperative and postoperative complications, hospitalisation period and patient satisfaction were recorded. Postoperative questionnaires were re-filled in. Patients were evaluated at 1st and 6th weeks.Results: In both group of patients, symptomatic and anatomic relief was significantly high. Whilst both operation results in terms of postoperative early complications were similar, postoperative pelvic pain were lower and hospitalisation period was shorter. (2.6±0.9 versus 3.7±1.0 p<0.01)Conclusion: In the treatment of apical prolapsus, though PIVS and SSLF?s short term success rates were similar, PIVS seems to be advantageous with low postoperative pain and short hospitalisation period.Key Words: Pelvic organ prolapse (POP), Posterior intravaginal sling (PIVS), Sacrospinous ligament fixation (SSLF).