Delayed complications of intravaginal slingplasty multifilament tape: two case reports

We would like to present two cases of delayed complications of intravaginal slingplasty (IVS) suburethral sling in Penang, Malaysia. There were two patients who were referred to us for problems subsequent to suburethral sling surgery using the IVS sling. These patients were reviewed and subsequently treated. The first patient presented with a bleeding granuloma. She underwent surgery and intra operatively the granuloma was excised. On exploration there was remnant of the tape bilaterally. The tape was easily excised with traction. A diagnostic cystoscopy did not show any abnormality. The second patient presented with a severe sling exposure. This patient also had surgery to excise the sling. It was easily dislodged with traction and removed completely. There were pus collections on one side. On subsequent review both patients were well with no more vaginal bleeding or discharge. Both patients however remained continent. This report is to show IVS sling complications may present in different manner and the need for attending physician to be aware of these presentations. They should be aware of the delayed presentation of these complications.

Posterior Intravaginal Slingplasty versus Unilateral Sacrospinous Ligament Fixation in Treatment of Vaginal Vault Prolapse

Objective. To investigate the differences in efficacy, postoperative complications, and patient satisfaction between posterior intravaginal slingplasty (PIVS) and unilateral sacrospinous ligament fixation (SSLF) procedures. Study Design. A retrospective study of thirty-three women who underwent PIVS or SSLF treatment for vaginal vault prolapse in Oulu University Hospital. The patients were invited to a follow-up visit to evaluate the objective and subjective outcomes. Median follow-up time was 16 months (range 6–52). The anatomical outcome was detected by the Pelvic Organ Prolapse Quantification (POP-Q) system. Information on urinary, bowel, and sexual dysfunctions and overall satisfaction was gathered with specific questionnaire. The data were analyzed using Mann-Whitney U test and Fisher’s exact test. Results. Mesh erosion was found in 4 (25%) patients in the PIVS group. Anatomical stage II prolapse or worse (any POP-Q point ≥−1) was detected in 8 (50%) patients in the PIVS group and 9 (53%) patients in the SSLF group. Overall satisfaction rates were 62% and 76%, respectively. Conclusion. The efficacy of PIVS and SSLF is equally poor, and the rate of vaginal erosion is intolerably high with the PIVS method. Based on our study, we cannot recommend the usage of either technique in operative treatment of vaginal vault prolapse.