Bilan des prises en charge thérapeutiques d’un prolapsus utérin View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2009-09

AUTHORS

R. de Tayrac, L. Wagner, M. -L. Mathé, P. Costa, P. Marès

ABSTRACT

Uterine prolapse is an intra-vaginal or extra-vulvae uterine descent. That frequent pathology is mainly due to the weakness of the uterosacral complex suspension system. Preoperatively, cervical cytology and ultrasound should be performed looking for an associated uterine pathology, and other pelvic floor disorders should be systematically checked. A pessary should be proposed before surgery, even for young women, because of its relative efficacy and safety. Surgical treatment is still the reference management, but is only indicated for symptomatic cases. Abdominal sacrocolpopexy is currently the gold standard for uterine suspension. Sacrocolpopexy is more efficient than vaginal sacrospinous suspension (Richter procedure), with a decreased rate of postoperative dyspareunia. Laparoscopic approach seems to be as efficient as open abdominal surgery, and is currently recommended as the first line. On elderly, vaginal reconstructive surgery has well known advantages. For the vaginal route, sacrospinous suspension is the reference technique. Sacrospinous suspension with uterine conservation (Richardson procedure) is as efficient as sacrospinous suspension associated with hysterectomy. Infracoccygeal sacropexy (“posterior IVS” procedure) is as efficient as sacrospinous suspension at medium-term, with a decreased rate of early postoperative pain and cystocele recurrence. More... »

PAGES

218-225

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s11608-009-0257-6

DOI

http://dx.doi.org/10.1007/s11608-009-0257-6

DIMENSIONS

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