REPAIR OF POSTERIOR VAGINAL WALL DEFECTS WITH PELVICOL IMPLANT ANCHORED TO ILIOCOCCYGEUS

Pelvic floor prolapse is a frequent condition in the female population, inevitably deemed to increase with the population average age increase. If quality of life of women suffering from pelvic prolapse is investigated, the impact of symptoms may result dramatic, causing psychological, relational, sexual, working problems. Posterior vaginal wall defects are classified as rectocele and enterocele. Rectocele means hernia or protrusion of the anterior wall of rectum in vagina, such condition being determined both by softening of posterior vaginal wall and by damaging of lateral insertions of the vagina to the pelvic wall. RIASSUNTO Il descensus del pavimento pelvico è una condizione frequente nella popolazione femminile, destinata inevitabilmente ad aumentare con l’aumento dell’età media della popolazione. Se si indaga sulla qualità della vita delle donne affette da descensus pelvico, risulta che l’impatto dei sintomi può essere drammatico, creando problemi psicologici, relazionali, sessuali ed occupazionali. I difetti della parete vaginale posteriore vengono classificati come rettocele ed enterocele. Per rettocele s’intende l’ernia o protrusione della parete anteriore del retto in vagina, tale condizione può essere determinata sia da un’attenuazione della paAim of the study is to use a surgical technique for the treatment of posterior vaginal wall defects and a type of prosthetic material that solves the pathology, being in the meanwhile the least invasive as possible, not having high costs and not leaving physical and/or psychological invalidating problems. In the choice of the type of surgical intervention to be carried out for the correction of an anatomical and/or functional defect is necessary to carefully evaluate the impact that this intervention may cause to women’s life and - as the evidencebased medicine imposes - it is necessary to evaluate the adequacy of medical interventions as to the possibility that they offer to promote or regain health. The surgical technique used foresees a transversal incision of the posterior vaginal wall at the rima vulvae with detachment of the vagina and exposure of the rectovaginal septum up to the posterior fornixes. Exposing the ischial spine, a Vicryl point is given bilaterally 1 cm forward and upward to the spine itself. Thus the PelvocolTM tape is fixed with the same thread that consequently anchors the wall of the vaginal fundus, De Lancey II-III point. With this technique the musculi levatoris ani are not medialized, there are no sutures in the vagina, thus guaranteeing a normal anatomy and a normal vaginal