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O129 OFFICE HYSTEROSCOPIC MYOMECTOMY: EFFECTIVE AND EFFICIENT PROCEDURE
Free communication (oral) presentations / International Journal of Gynecology & Obstetrics 119S3 (2012) S261–S530
health for stabilizing patient before transfer to higher facility, they noted lack of knowledge to give the intervention, fear attitude recognizing the side effects of MgSO4, and lack of effort by midwife and the stakeholders to improve their skill competency to use the medicine as mentioned in the institutional guidelines. Care had barriers of limited drugs and availability of equipment and the efforts from health department to review the feasibility of the midwife practice were not been completely considered. The influence of social factors also contributed to the delay of management to transfer patient and the difficulty of midwife to make a clinical decision making. Conclusions: The case study highlights the complexities of barriers to optimize the utilization of MgSO4 in referral case from midwife in private practice to higher facilities. A better understanding of midwife clinical competency and standard obstetrics practice to facilitate management of preeeclampsia should be the main focus intervention by stakeholders to improve the midwife capacity in translation the evidence of clinical practice. O127 SCAR PREGNANCIES: EARLY DIAGNOSIS ALLOWS CONSERVATIVE NON SURGICAL MANAGEMENT L. Giambanco1 , T. Doveri1 , M.L. Amico1 , F. Forlani1 , D. Incandela1 , L. Alio1 , G. Cali’1 . 1 Obstetrics and Gynecology Department Civico Hospital, Palermo, Italy Objectives: Scar pregnancy is an ectopic pregnancy with a peculiar localization of placenta on/in previous hysterotomy site. Scar pregnancy could be cause of placenta accreta, uterine rupture, massive hemorrhage and so on. Early diagnosis of abnormal localization could preserve the woman from dangerous and life-threatening complications and her fertility as well. Transvaginal sonography performed in first trimester can identify scar pregnancies. Materials: Between 2009 and 2011 we diagnosed 16 scar pregnancies by transvaginal and transabdominal sonography, all of these patients had at least 1 previous caesarean section. Methods: Diagnostic criteria we look for are (fig. 1): an intrauterine gestational sac with localization on the anterior uterine wall, at internal orifice, thinnening of myometrial layer, defect of decidua basalis between placenta and myometrium and abnormal placental vascularization. Our purpose was to identify as soon as possible scar pregnancies in order to reduce maternal morbidity and mortality.
Figure 1. Results: In 14 of these women we were able to identify the abnormal localization on gestational sac at 7–12 weeks. All of them underwent conservative treatment: local or systemic Metotrexate, echoguided curettage after uterine arteries embolization. In two patients we performed an emergency laparotomy because of acute and massive hemorrhage.
S305
Conclusions: Diagnostic accuracy of ultrasonography in seconda and third trimester of pregnancy is higher, but the timing of diagnosis is too late for preventing major complications. Early first trimester diagnosis enable a conservative management, as reported by Literature and our data. O128 ISOBARIC MYOMECTOMY: SURGICAL AND REPRODUCTIVE OUTCOMES OF 5 YEARS EXPERIENCE G. Cammareri1 , C. Lanzani1 , F. Cirillo1 , E.A. Macalli1 , A. Turri1 , S. Rehman1 , F. Buzzella1 , E.M. Ferrazzi1 . 1 Hsp Buzzi, Milano, Milano, Italy Objectives: To investigate the feasibility of isobaric myomectomy and the reproductive outcomes. Materials: We performed a retrospective analysis of 207 isobaric myomectomies, between October 2005 and December 2010Methods: We included all women with 1 or more uterine myomas measuring more than 4 cm, symptomatic or progressively enlarging that underwent isobaric myomectomy, using a subcutaneous lifting system and laparotomic instruments. For reproductive outcomes, we performed a telephonic follow up, including 109 women aged less than 43 years. Results: The number of myomas removed per patient was 2.2±1.9 and diameter of the biggest fibroid was 7.0±2.5 cm. The biggest fibroid was intramural in 76% and subserosal in 24% of cases. The median operating time was 95 [70–125] minutes with a correlation with total volume of myomas, maximum volume and number of myomas removed. The mean blood loss was 200 [100– 450] mL. No intra-operative local vasoconstrictive drugs were used. Ninety-seven interventions were performed under spinalepidural anesthesia (46.9%) and 110 under general anesthesia. The conversion rate to laparotomic procedure was 5.8%. Blood transfusion rate was 2%. Two major complications (1%) were observed after the procedure: two cases of haemoperitoneum respectively caused by bleeding from the major ancillary port and from the uterine suture and treated by laparotomic intervention. No conversions to hysterectomy were performed. For reproductive outcomes, we included 109 women: in this cohort, no conversions to laparotomy were required. Six months waiting period after surgery was suggested. After intervention, 33 women wished to conceive and 26 became pregnant. There were no significant differences in clinical and demographic characteristics between women who conceived and women who did not. Early miscarriage occurred in 4 cases. Eleven patients delivered by elective Caesarean Section. Eleven women underwent a trial of labour and 9 women delivered vaginally. No uterine rupture occurred. Conclusions: Isobaric gasless myomectomy is a safe and reliable procedure, it has good reproductive outcome and it is possible to be performed under spinal-epidural anaesthesia, both for large and multiple intramural or subserosal uterine myomas. In our survey, although with small numbers, we did not have any uterine rupture, even in trial of labour. This fact could confirm the strength and safety of the uterine suture of myomectomy performed during gasless interventions, using traditional laparotomic instruments O129 OFFICE HYSTEROSCOPIC MYOMECTOMY: EFFECTIVE AND EFFICIENT PROCEDURE G. Cammareri1 , A. Turri1 , C. Lanzani1 , S. Rehman1 , F. Cirillo1 , F. Buzzella1 , E.M. Ferrazzi1 , S. Di Francesco1 . 1 Ospedale Vittore Buzzi, Milano, Italy Objectives: Hysteroscopic myomectomy is the standard minimally invasive surgical procedure for treating submucous fibroids. Office hysteroscopic myomectomy is a safe and well tolerated procedure. Submucosal myomas G0 and G1 <15mm may be successfully treated in an outpatient setting. On the contrary, there is still no single technique proven to be equally superior for treating G2
S306
Free communication (oral) presentations / International Journal of Gynecology & Obstetrics 119S3 (2012) S261–S530
myomas and myomas greater than 15mm. With this study we assess the feasibility, safety and acceptability of office hysteroscopic myomectomy in submucosal G0, G1 and G2 myomas and the feasibility of a multi-step approach for large myomas. Materials: In our Outpatient clinic of Obstetrics and Gynaecology from January 2009 to December 2011 we conducted a prospective observational study of 94 consecutive office hysteroscopic myomectomies. We enrolled 66 women with one or more submucosal myomas that were histologically confirmed. Methods: We performed office hysteroscopic myomectomy using the 5mm continuous flow office hysteroscope with bipolar instruments (Versapoint, Gynecare). Myomectomies were performed with slicing technique and in multiple step approach for myomas >25mm. All hysteroscopies were performed by the same operator without any anaesthetic support. Patients scored their pain by the VNRS after all procedures. All patients underwent a transvaginal ultrasound follow up. Results: 66 patients were enrolled (mean age±SD=45±8.8). A total of 81 myomas were treated (35 G0, 33 G1 and 13 G2). Eleven patients had multiple myomas: eight had 2 myomas, two had 3 and one had four myomas. The mean diameter of the fibroids was 18 mm (ir 13–2 mm). The average operating time for each procedure was 10±4minutes. On an average each patient was subjected to 1.45 hysteroscopies. We observed 5 cases of minor complications (5.3%): 2 cases of pelvic pain and 3 cases of vasovagal reaction. No major complications occurred. The successful rate of the procedure was 80.3%. 13 patients were sent to operating room to complete the myomectomy with standard resectoscope. The average value of VNRS was 2.9±1.4. On follow up of the patients no intracavitary lesion was observed. Conclusions: Office hysteroscopic myomectomy is a very effective procedure, with a good successful rate (80.2%) even for big myomas (up to 40 mm). With multistep approach we have the possibility to treat large submucosal myomas, and myomas with an intramural development. The procedure is safe, with minor complication rate and is well tolerated even without any anaesthetic support. O130 COMMERCIAL SEXUAL EXPLOITATION OF CHILDREN (CSEC): PROFILES OF FEMALE VICTIMS, CONTRIBUTING FACTORS, LIFE EXPERIENCES AND SEXUALLY TRANSMITTED INFECTIONS R.B. Capitulo1 . 1 Obstetrics and Gynecology, UERM Memorial Medical Center College of Medicine, Quezon City, Philippines Objectives: Commercial sexual exploitation of children (CSEC) is a term used to describe the various activities that exploit children for their commercial value including child sex tourism, child prostitution, child pornography and the trafficking of children for sexual purposes. This study was undertaken to determine the sociodemographic factors, circumstances leading to sexual exploitation, working conditions, sexual behavior, physical findings and sexually transmitted infections among institutionalized female CSEC workers. Materials: A total of 237 female CSEC workers living in various rescue and rehabilitation centers of non-governmental organizations in Manila, Philippines, were interviewed and included in the study. Methods: This involved the use of a variety of research techniques such as one-on-one interviews, focused group discussions, content analysis of personal profile counseling protocols and observations. The social workers attending to them served as key informants as well. Each subject underwent a detailed gynecologic examination with collection of specimens for gram stain and Pap smear. Blood samples were then obtained to screen for syphilis, hepatitis B and HIV. Results: The female CSEC workers in this study were 8–16 years old with an average age of 14 years. Poverty remains to be the single most important factor that led these girls to commercial sexual
exploitation. Most of them (91%) left their homes and lived in the streets of Metro Manila for a variable period of time. A majority (65%) experienced some form of sexual abuse. Most of the girls first engaged in CSEC work at 12 years old (62%) while 2 of them were initiated into the trade at the young age of 7. All of the subjects had physical examination findings consistent with repeated vaginal penetration, 11 had active gonococcal infection, 28 were diagnosed with late latent syphilis while 41 had chronic active hepatitis B. None of the subjects tested positive for HIV. Conclusions: This study has enabled us to identify the different levels of intervention that can be done in order to curb the problem of commercial sexual exploitation of children (CSEC). The results have also served as guide for the holistic (physical, mental, emotional, spiritual) rehabilitation of rescued CSEC workers living in institutions. O131 EFFECTS OF INTRAVAGINAL ESTRIOL AND PELVIC FLOOR REHABILITATION ON UROGENITAL AGING IN POSTMENOPAUSAL WOMEN G. Capobianco1 , E. Donolo1 , M. Farina1 , F. Dessole1 , C. Cherchi1 , M. Dessole1 , P.L. Cherchi1 . 1 Gynecologic and Obstetric Clinic, University of Sassari, Sassari, Sardinia, ITALY, Italy Objectives: To assess the effects of the combination of pelvic floor rehabilitation and intravaginal estriol administration on stress urinary incontinence (SUI), urogenital atrophy and recurrent urinary tract infections in postmenopausal women. Materials: Two-hundred-six postmenopausal women with urogenital aging symptoms were enrolled in this prospective randomized controlled study. Patients were randomly divided into two groups and each group consisted of 103 women. Subjects in the treatment group received intravaginal estriol ovules, such as 1 ovule (1 mg) once daily for 2 weeks and then 2 ovules once weekly for a total of 6 months as maintenance therapy plus pelvic floor rehabilitation. Subjects in the control group received only intravaginal estriol in a similar regimen. Methods: We evaluated urogenital symptomatology, urine cultures, colposcopic findings, urethral cytologic findings, urethral pressure profiles and urethrocystometry before, as well as after 6 months of treatment. Results: After therapy, the symptoms and signs of urogenital atrophy significantly improved in both groups. 61/83 (73.49%) of the treated patients, and only 10/103 (9.71%) of the control patients referred a subjective improvement of their incontinence. In the patients treated by combination therapy with estriol plus pelvic floor rehabilitation, we observed significant improvements of colposcopic findings, and there were statistically significant increases in mean maximum urethral pressure (MUP), in mean urethral closure pressure (MUCP), as well as in the abdominal pressure transmission ratio to the proximal urethra (PTR). Conclusions: Our results showed that combination therapy with estriol plus pelvic floor rehabilitation was effective and should be considered as a first-line treatment for symptoms of urogenital aging in postmenopausal women. O132 POSTERIOR INTRAVAGINAL SLINGPLASTY FOR VAGINAL PROLAPSE: 7 YEARS FOLLOW-UP G. Capobianco1 , E. Donolo1 , M. Farina1 , F. Dessole1 , C. Cherchi1 , M. Dessole1 , P.L. Cherchi1 , S. Dessole1 . 1 Gynecologic and Obstetric Clinic, University of Sassari, Sassari, Sardinia, ITALY, Italy Objectives: To evaluate the efficacy of the posterior intravaginal slingoplasty (IVS) for the treatment of vaginal prolapse. Materials: 44 patients who had undergone posterior IVS procedures were analyzed. The median age of the patients was 61 years (range 44–77). The median parity was 3 (range 1–4). Methods: We inserted a mesh (polypropylene) in the rectovaginal space, from the posterior IVS tape posterior to the vaginal vault
health for stabilizing patient before transfer to higher facility, they noted lack of knowledge to give the intervention, fear attitude recognizing the side effects of MgSO4, and lack of effort by midwife and the stakeholders to improve their skill competency to use the medicine as mentioned in the institutional guidelines. Care had barriers of limited drugs and availability of equipment and the efforts from health department to review the feasibility of the midwife practice were not been completely considered. The influence of social factors also contributed to the delay of management to transfer patient and the difficulty of midwife to make a clinical decision making. Conclusions: The case study highlights the complexities of barriers to optimize the utilization of MgSO4 in referral case from midwife in private practice to higher facilities. A better understanding of midwife clinical competency and standard obstetrics practice to facilitate management of preeeclampsia should be the main focus intervention by stakeholders to improve the midwife capacity in translation the evidence of clinical practice. O127 SCAR PREGNANCIES: EARLY DIAGNOSIS ALLOWS CONSERVATIVE NON SURGICAL MANAGEMENT L. Giambanco1 , T. Doveri1 , M.L. Amico1 , F. Forlani1 , D. Incandela1 , L. Alio1 , G. Cali’1 . 1 Obstetrics and Gynecology Department Civico Hospital, Palermo, Italy Objectives: Scar pregnancy is an ectopic pregnancy with a peculiar localization of placenta on/in previous hysterotomy site. Scar pregnancy could be cause of placenta accreta, uterine rupture, massive hemorrhage and so on. Early diagnosis of abnormal localization could preserve the woman from dangerous and life-threatening complications and her fertility as well. Transvaginal sonography performed in first trimester can identify scar pregnancies. Materials: Between 2009 and 2011 we diagnosed 16 scar pregnancies by transvaginal and transabdominal sonography, all of these patients had at least 1 previous caesarean section. Methods: Diagnostic criteria we look for are (fig. 1): an intrauterine gestational sac with localization on the anterior uterine wall, at internal orifice, thinnening of myometrial layer, defect of decidua basalis between placenta and myometrium and abnormal placental vascularization. Our purpose was to identify as soon as possible scar pregnancies in order to reduce maternal morbidity and mortality.
Figure 1. Results: In 14 of these women we were able to identify the abnormal localization on gestational sac at 7–12 weeks. All of them underwent conservative treatment: local or systemic Metotrexate, echoguided curettage after uterine arteries embolization. In two patients we performed an emergency laparotomy because of acute and massive hemorrhage.
S305
Conclusions: Diagnostic accuracy of ultrasonography in seconda and third trimester of pregnancy is higher, but the timing of diagnosis is too late for preventing major complications. Early first trimester diagnosis enable a conservative management, as reported by Literature and our data. O128 ISOBARIC MYOMECTOMY: SURGICAL AND REPRODUCTIVE OUTCOMES OF 5 YEARS EXPERIENCE G. Cammareri1 , C. Lanzani1 , F. Cirillo1 , E.A. Macalli1 , A. Turri1 , S. Rehman1 , F. Buzzella1 , E.M. Ferrazzi1 . 1 Hsp Buzzi, Milano, Milano, Italy Objectives: To investigate the feasibility of isobaric myomectomy and the reproductive outcomes. Materials: We performed a retrospective analysis of 207 isobaric myomectomies, between October 2005 and December 2010Methods: We included all women with 1 or more uterine myomas measuring more than 4 cm, symptomatic or progressively enlarging that underwent isobaric myomectomy, using a subcutaneous lifting system and laparotomic instruments. For reproductive outcomes, we performed a telephonic follow up, including 109 women aged less than 43 years. Results: The number of myomas removed per patient was 2.2±1.9 and diameter of the biggest fibroid was 7.0±2.5 cm. The biggest fibroid was intramural in 76% and subserosal in 24% of cases. The median operating time was 95 [70–125] minutes with a correlation with total volume of myomas, maximum volume and number of myomas removed. The mean blood loss was 200 [100– 450] mL. No intra-operative local vasoconstrictive drugs were used. Ninety-seven interventions were performed under spinalepidural anesthesia (46.9%) and 110 under general anesthesia. The conversion rate to laparotomic procedure was 5.8%. Blood transfusion rate was 2%. Two major complications (1%) were observed after the procedure: two cases of haemoperitoneum respectively caused by bleeding from the major ancillary port and from the uterine suture and treated by laparotomic intervention. No conversions to hysterectomy were performed. For reproductive outcomes, we included 109 women: in this cohort, no conversions to laparotomy were required. Six months waiting period after surgery was suggested. After intervention, 33 women wished to conceive and 26 became pregnant. There were no significant differences in clinical and demographic characteristics between women who conceived and women who did not. Early miscarriage occurred in 4 cases. Eleven patients delivered by elective Caesarean Section. Eleven women underwent a trial of labour and 9 women delivered vaginally. No uterine rupture occurred. Conclusions: Isobaric gasless myomectomy is a safe and reliable procedure, it has good reproductive outcome and it is possible to be performed under spinal-epidural anaesthesia, both for large and multiple intramural or subserosal uterine myomas. In our survey, although with small numbers, we did not have any uterine rupture, even in trial of labour. This fact could confirm the strength and safety of the uterine suture of myomectomy performed during gasless interventions, using traditional laparotomic instruments O129 OFFICE HYSTEROSCOPIC MYOMECTOMY: EFFECTIVE AND EFFICIENT PROCEDURE G. Cammareri1 , A. Turri1 , C. Lanzani1 , S. Rehman1 , F. Cirillo1 , F. Buzzella1 , E.M. Ferrazzi1 , S. Di Francesco1 . 1 Ospedale Vittore Buzzi, Milano, Italy Objectives: Hysteroscopic myomectomy is the standard minimally invasive surgical procedure for treating submucous fibroids. Office hysteroscopic myomectomy is a safe and well tolerated procedure. Submucosal myomas G0 and G1 <15mm may be successfully treated in an outpatient setting. On the contrary, there is still no single technique proven to be equally superior for treating G2
S306
Free communication (oral) presentations / International Journal of Gynecology & Obstetrics 119S3 (2012) S261–S530
myomas and myomas greater than 15mm. With this study we assess the feasibility, safety and acceptability of office hysteroscopic myomectomy in submucosal G0, G1 and G2 myomas and the feasibility of a multi-step approach for large myomas. Materials: In our Outpatient clinic of Obstetrics and Gynaecology from January 2009 to December 2011 we conducted a prospective observational study of 94 consecutive office hysteroscopic myomectomies. We enrolled 66 women with one or more submucosal myomas that were histologically confirmed. Methods: We performed office hysteroscopic myomectomy using the 5mm continuous flow office hysteroscope with bipolar instruments (Versapoint, Gynecare). Myomectomies were performed with slicing technique and in multiple step approach for myomas >25mm. All hysteroscopies were performed by the same operator without any anaesthetic support. Patients scored their pain by the VNRS after all procedures. All patients underwent a transvaginal ultrasound follow up. Results: 66 patients were enrolled (mean age±SD=45±8.8). A total of 81 myomas were treated (35 G0, 33 G1 and 13 G2). Eleven patients had multiple myomas: eight had 2 myomas, two had 3 and one had four myomas. The mean diameter of the fibroids was 18 mm (ir 13–2 mm). The average operating time for each procedure was 10±4minutes. On an average each patient was subjected to 1.45 hysteroscopies. We observed 5 cases of minor complications (5.3%): 2 cases of pelvic pain and 3 cases of vasovagal reaction. No major complications occurred. The successful rate of the procedure was 80.3%. 13 patients were sent to operating room to complete the myomectomy with standard resectoscope. The average value of VNRS was 2.9±1.4. On follow up of the patients no intracavitary lesion was observed. Conclusions: Office hysteroscopic myomectomy is a very effective procedure, with a good successful rate (80.2%) even for big myomas (up to 40 mm). With multistep approach we have the possibility to treat large submucosal myomas, and myomas with an intramural development. The procedure is safe, with minor complication rate and is well tolerated even without any anaesthetic support. O130 COMMERCIAL SEXUAL EXPLOITATION OF CHILDREN (CSEC): PROFILES OF FEMALE VICTIMS, CONTRIBUTING FACTORS, LIFE EXPERIENCES AND SEXUALLY TRANSMITTED INFECTIONS R.B. Capitulo1 . 1 Obstetrics and Gynecology, UERM Memorial Medical Center College of Medicine, Quezon City, Philippines Objectives: Commercial sexual exploitation of children (CSEC) is a term used to describe the various activities that exploit children for their commercial value including child sex tourism, child prostitution, child pornography and the trafficking of children for sexual purposes. This study was undertaken to determine the sociodemographic factors, circumstances leading to sexual exploitation, working conditions, sexual behavior, physical findings and sexually transmitted infections among institutionalized female CSEC workers. Materials: A total of 237 female CSEC workers living in various rescue and rehabilitation centers of non-governmental organizations in Manila, Philippines, were interviewed and included in the study. Methods: This involved the use of a variety of research techniques such as one-on-one interviews, focused group discussions, content analysis of personal profile counseling protocols and observations. The social workers attending to them served as key informants as well. Each subject underwent a detailed gynecologic examination with collection of specimens for gram stain and Pap smear. Blood samples were then obtained to screen for syphilis, hepatitis B and HIV. Results: The female CSEC workers in this study were 8–16 years old with an average age of 14 years. Poverty remains to be the single most important factor that led these girls to commercial sexual
exploitation. Most of them (91%) left their homes and lived in the streets of Metro Manila for a variable period of time. A majority (65%) experienced some form of sexual abuse. Most of the girls first engaged in CSEC work at 12 years old (62%) while 2 of them were initiated into the trade at the young age of 7. All of the subjects had physical examination findings consistent with repeated vaginal penetration, 11 had active gonococcal infection, 28 were diagnosed with late latent syphilis while 41 had chronic active hepatitis B. None of the subjects tested positive for HIV. Conclusions: This study has enabled us to identify the different levels of intervention that can be done in order to curb the problem of commercial sexual exploitation of children (CSEC). The results have also served as guide for the holistic (physical, mental, emotional, spiritual) rehabilitation of rescued CSEC workers living in institutions. O131 EFFECTS OF INTRAVAGINAL ESTRIOL AND PELVIC FLOOR REHABILITATION ON UROGENITAL AGING IN POSTMENOPAUSAL WOMEN G. Capobianco1 , E. Donolo1 , M. Farina1 , F. Dessole1 , C. Cherchi1 , M. Dessole1 , P.L. Cherchi1 . 1 Gynecologic and Obstetric Clinic, University of Sassari, Sassari, Sardinia, ITALY, Italy Objectives: To assess the effects of the combination of pelvic floor rehabilitation and intravaginal estriol administration on stress urinary incontinence (SUI), urogenital atrophy and recurrent urinary tract infections in postmenopausal women. Materials: Two-hundred-six postmenopausal women with urogenital aging symptoms were enrolled in this prospective randomized controlled study. Patients were randomly divided into two groups and each group consisted of 103 women. Subjects in the treatment group received intravaginal estriol ovules, such as 1 ovule (1 mg) once daily for 2 weeks and then 2 ovules once weekly for a total of 6 months as maintenance therapy plus pelvic floor rehabilitation. Subjects in the control group received only intravaginal estriol in a similar regimen. Methods: We evaluated urogenital symptomatology, urine cultures, colposcopic findings, urethral cytologic findings, urethral pressure profiles and urethrocystometry before, as well as after 6 months of treatment. Results: After therapy, the symptoms and signs of urogenital atrophy significantly improved in both groups. 61/83 (73.49%) of the treated patients, and only 10/103 (9.71%) of the control patients referred a subjective improvement of their incontinence. In the patients treated by combination therapy with estriol plus pelvic floor rehabilitation, we observed significant improvements of colposcopic findings, and there were statistically significant increases in mean maximum urethral pressure (MUP), in mean urethral closure pressure (MUCP), as well as in the abdominal pressure transmission ratio to the proximal urethra (PTR). Conclusions: Our results showed that combination therapy with estriol plus pelvic floor rehabilitation was effective and should be considered as a first-line treatment for symptoms of urogenital aging in postmenopausal women. O132 POSTERIOR INTRAVAGINAL SLINGPLASTY FOR VAGINAL PROLAPSE: 7 YEARS FOLLOW-UP G. Capobianco1 , E. Donolo1 , M. Farina1 , F. Dessole1 , C. Cherchi1 , M. Dessole1 , P.L. Cherchi1 , S. Dessole1 . 1 Gynecologic and Obstetric Clinic, University of Sassari, Sassari, Sardinia, ITALY, Italy Objectives: To evaluate the efficacy of the posterior intravaginal slingoplasty (IVS) for the treatment of vaginal prolapse. Materials: 44 patients who had undergone posterior IVS procedures were analyzed. The median age of the patients was 61 years (range 44–77). The median parity was 3 (range 1–4). Methods: We inserted a mesh (polypropylene) in the rectovaginal space, from the posterior IVS tape posterior to the vaginal vault