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Fatton B, de Tayrac R, Letouzey V, Huberlant S. Pelvic organ prolapse and sexual function. Nat Rev Urol 2020; 17:373-390. [DOI: 10.1038/s41585-020-0334-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/05/2020] [Indexed: 11/09/2022]
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Capmas P, Tixier S, Neveu ME, Fernandez H. Vaginal posterior isthmic sling: A report of 53 cases. J Gynecol Obstet Hum Reprod 2020; 49:101778. [PMID: 32360485 DOI: 10.1016/j.jogoh.2020.101778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 04/17/2020] [Accepted: 04/21/2020] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Sacrospinofixation is used for fundic vaginal vault's prolapse or to prevent mid-level or posterior prolapse. It can lead to complications such as dyspareunia, chronic pain, and quality of life impairment. Anchoring a posterior isthmic sling to the two sacrospinous ligaments is an alternative to classic Richter's sacrospinofixation. Objective of this study is to report the first cases of vaginal posterior isthmic slings. METHODS This study is retrospective and unicentric. It includes women who had posterior isthmic sling at the time of a surgery with a mesh for anterior prolapse by vaginal way between 2010 and 2016 in the gynecologic department of a teaching hospital. Report of efficacy and tolerance was performed. RESULTS Between 2010 and 2016, 53 women were included with a posterior isthmic sling and a mesh for an anterior prolapse. POP-Q evolution during the follow-up in the posterior isthmic sling group assess of a good efficacy of the sling. Four women (7.5%) required second surgery in 28 months following initial surgery (only 1 for excision). Four women (7.5%) had a prolapse recurrence in a mean time of 30 months without recurrent surgery. Women's satisfaction level was high (8.0/10 [7,1-8,8]). CONCLUSION Efficacy and tolerance of the posterior isthmic sling seems good. It might then be an option for mid-level prolapses in case of vaginal surgery with mesh for anterior prolapse. A non-inferiority trial should be performed to be able to conclude on the place of this alternative to Richter's sacrospinofixation.
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Affiliation(s)
- Perrine Capmas
- AP-HP, GHU-Sud, Hospital Bicêtre, Department of Gynecology and Obstetrics, 78 rue du Général Leclerc, 94270 Le Kremlin Bicêtre, France; Faculty of Medicine, University Paris-Sud Saclay, 63 rue Gabriel Péri, 94270 Le Kremlin Bicêtre, France; Université Paris-Saclay, UVSQ, Inserm, CESP, 94807 Villejuif, France.
| | - Sarah Tixier
- AP-HP, GHU-Sud, Hospital Bicêtre, Department of Gynecology and Obstetrics, 78 rue du Général Leclerc, 94270 Le Kremlin Bicêtre, France
| | - Marie-Emmanuelle Neveu
- AP-HP, GHU-Sud, Hospital Bicêtre, Department of Gynecology and Obstetrics, 78 rue du Général Leclerc, 94270 Le Kremlin Bicêtre, France
| | - Hervé Fernandez
- AP-HP, GHU-Sud, Hospital Bicêtre, Department of Gynecology and Obstetrics, 78 rue du Général Leclerc, 94270 Le Kremlin Bicêtre, France; Faculty of Medicine, University Paris-Sud Saclay, 63 rue Gabriel Péri, 94270 Le Kremlin Bicêtre, France; Université Paris-Saclay, UVSQ, Inserm, CESP, 94807 Villejuif, France
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Hugele F, Panel L, Farache C, Kashef A, Cornille A, Courtieu C. Two years follow up of 270 patients treated by transvaginal mesh for anterior and/or apical prolapse. Eur J Obstet Gynecol Reprod Biol 2017; 208:16-22. [DOI: 10.1016/j.ejogrb.2016.10.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Revised: 09/23/2016] [Accepted: 10/18/2016] [Indexed: 10/20/2022]
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Chevrot A, Droupy S, Linares E, de Tayrac R, Costa P, Wagner L. Impact de la promontofixation cœlioscopique sur les symptômes pelviens, la qualité de vie et la sexualité : résultats à 3ans d’une étude prospective. Prog Urol 2016; 26:558-65. [DOI: 10.1016/j.purol.2016.02.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2015] [Revised: 02/21/2016] [Accepted: 02/23/2016] [Indexed: 11/26/2022]
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Cour F, Le Normand L, Meurette G. Traitement par voie basse des colpocèles postérieures : recommandations pour la pratique clinique. Prog Urol 2016; 26 Suppl 1:S47-60. [DOI: 10.1016/s1166-7087(16)30428-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Kdous M, Zhioua F. 3-year results of transvaginal cystocele repair with transobturator four-arm mesh: A prospective study of 105 patients. Arab J Urol 2014; 12:275-84. [PMID: 26019962 PMCID: PMC4435760 DOI: 10.1016/j.aju.2014.09.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2014] [Revised: 05/01/2014] [Accepted: 09/24/2014] [Indexed: 10/26/2022] Open
Abstract
OBJECTIVES To evaluate the long-term efficacy and safety of transobturator four-arm mesh for treating cystoceles. PATIENTS AND METHODS In this prospective study, 105 patients had a cystocele corrected between January 2004 and December 2008. All patients had a symptomatic cystocele of stage ⩾2 according to the Baden-Walker halfway stratification. We used only the transobturator four-arm mesh kit (Surgimesh®, Aspide Medical, France). All surgical procedures were carried out by the same experienced surgeon. The patients' characteristics and surgical variables were recorded prospectively. The anatomical outcome, as measured by a physical examination and postoperative stratification of prolapse, and functional outcome, as assessed by a questionnaire derived from the French equivalents of the Pelvic Floor Distress Inventory, Pelvic Floor Impact Questionnaire and the Pelvic Organ Prolapse-Urinary Incontinence-Sexual Questionnaire, were considered as the primary outcome measures. Peri- and postoperative complications constituted the secondary outcome measures. RESULTS At 36 months after surgery the anatomical success rate (stage 0 or 1) was 93%. On a functional level, all the scores of quality of life and sexuality were improved. The overall satisfaction score (visual analogue scale) was 71.4%. There were no perioperative adverse events. Mesh erosion was reported in 7.6% and mesh retraction in 5.7% of the patients. CONCLUSIONS If the guidelines and precautions are followed, vaginal prosthetic surgery for genitourinary prolapse has shown long-term benefits. It provides excellent results both anatomically and functionally. However, complications are not negligible and some are specific to prosthetic surgery.
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Affiliation(s)
- Moez Kdous
- Department of Obstetrics and Gynecology, Aziza Othmana Hospital, Tunis, Tunisia
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Kozal S, Ripert T, Bayoud Y, Menard J, Nicolacopoulos I, Bednarzyck L, Staerman F, Larré S. Morbidity and functional mid-term outcomes using Prolift pelvic floor repair systems. Can Urol Assoc J 2014; 8:E605-9. [PMID: 25295130 DOI: 10.5489/cuaj.2022] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
INTRODUCTION We assess midterm morbidity and functional outcomes using the Prolift (Gynecare/Ethicon, Somerville, NJ) system and identify potential related risk factors. The Prolift mesh system to treat genital prolapse was introduced in 2005. It was withdrawn from the market in early 2013 after rising doubts about safety. METHODS Over a 7-year period, we retrospectively analyzed a cohort of 112 consecutive patients who underwent the Prolift procedure since 2006. Intraoperative and postoperative complications, anatomical and functional outcomes were recorded. RESULTS The median follow-up was 49.5 months (range: 16-85). The mean age was 64.7 ± 10.9 years (range: 40-86). Of the 112 patients, 74 patients had stage 3 (66.1%) and 8 patients had stage 4 (7.14%) vaginal prolapse. Prolift surgery was performed for pro-lapse recurrence for 26 patients (23.2%). Total mesh was used in 32 patients (29%), an isolated anterior mesh in 57 patients (51%) and an isolated posterior mesh in 23 patients (21%). Concomitant surgical procedures were performed for 44 patients (39.3%). Overall, 72% (18/25) of the complications were managed medically. We reported a failure rate of 8% (n = 9) occurring after a median follow-up of 9.5 months (range: 1-45). Among the 64 patients who had preoperative sexual activity (57.1%), de novo dyspareunia occurred in 9 patients (16.07%). We extracted predictive factors concerning failure, complications and sexuality. CONCLUSION Despite its market withdrawal, the Prolift system was associated with good midterm anatomic outcomes and few severe complications. Long-term follow-up data are still lacking, but surgeons and patients may be reassured.
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Affiliation(s)
- Sébastien Kozal
- Department of Urology and Andrology. Robert Debré, University Hospital, Reims, France
| | - Thomas Ripert
- Department of Urology and Andrology. Robert Debré, University Hospital, Reims, France; ; Department of Urology and Andrology, Polyclinic Courlancy, Reims, France
| | - Younes Bayoud
- Department of Urology and Andrology. Robert Debré, University Hospital, Reims, France
| | - Johan Menard
- Department of Urology and Andrology. Robert Debré, University Hospital, Reims, France
| | | | - Laurence Bednarzyck
- Department of Obstetrics and Gynecology, Manchester General Hospital, Charleville, France
| | - Frederic Staerman
- Department of Urology and Andrology. Robert Debré, University Hospital, Reims, France; ; Departement of Urology and Andrology, Polyclinic Les Bleuets, Reims, France
| | - Stéphane Larré
- Department of Urology and Andrology. Robert Debré, University Hospital, Reims, France
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Droupy S. Sexualité et pathologies urologiques. Presse Med 2014; 43:1106-10. [DOI: 10.1016/j.lpm.2014.05.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Accepted: 05/05/2014] [Indexed: 11/25/2022] Open
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Impact des cures de prolapsus pelviens par promontofixation laparoscopique sur la sexualité du couple. Prog Urol 2014; 24:247-55. [DOI: 10.1016/j.purol.2013.10.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2013] [Revised: 10/03/2013] [Accepted: 10/04/2013] [Indexed: 11/20/2022]
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Fatton B, Hermieu J, Cour F, Wagner L, Jacquetin B, de Tayrac R. Validation linguistique en français du Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire – Révisé IUGA (PISQ-IR). Prog Urol 2013; 23:1464-73. [DOI: 10.1016/j.purol.2013.10.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2013] [Revised: 10/03/2013] [Accepted: 10/04/2013] [Indexed: 10/26/2022]
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Schoenfeld M, Fuermetz A, Muenster M, Ennemoser S, von Bodungen V, Friese K, Jundt K. Sexuality in German urogynecological patients and healthy controls: is there a difference with respect to the diagnosis? Eur J Obstet Gynecol Reprod Biol 2013; 170:567-70. [PMID: 23988220 DOI: 10.1016/j.ejogrb.2013.08.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2013] [Revised: 07/06/2013] [Accepted: 08/01/2013] [Indexed: 01/01/2023]
Abstract
OBJECTIVE To evaluate sexual function among German urogynecological patients compared to a control group without urogynecological symptoms, using the validated German version of the Australian pelvic floor questionnaire. STUDY DESIGN Retrospective study including 313 women divided into five subgroups: women with stress urinary incontinence (SUI), overactive bladder (OAB), mixed incontinence (MI), pelvic organ prolapse (POP) and healthy controls. The self-administered questionnaire is divided into three domains: bladder, pelvic organ prolapse, and sexual function. It also includes severity, bothersomeness and condition-specific quality of life. Only completely filled out questionnaires were included. The Mann-Whitney U-test was used as a non-parametric test to calculate significances for ordinal data. A p-value <.05 was taken as significant. RESULTS 16/59 (27.1%) women in the control group were not sexually active compared to 19/60 (31.7%) in the SUI group, 51/98 (52.0%) in the mixed-incontinence group, 19/43 (44.2%) in the OAB group, and 24/53 (45.3%) in the prolapse group. Coital incontinence was present significantly more often in women with SUI (15/41, 36.6%) or mixed incontinence (20/44, 45.5%) than among the controls (1/49, 2.1%). Hence, concerning sexuality, women with urogynecological symptoms were all significantly more affected than the healthy controls. CONCLUSION The German version of the Australian pelvic floor questionnaire is a feasible tool to evaluate not only symptoms of urinary incontinence and pelvic organ prolapse but also sexual dysfunction. A substantial proportion of our urogynecological patients suffer immensely from problems with their sexuality, and it is therefore our responsibility as physicians to provide assistance and improve our education in this field.
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Affiliation(s)
- Mirjam Schoenfeld
- Department of Obstetrics and Gynecology, Ludwig-Maximilians-University Munich, Maistrasse, Germany
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Monforte M, Mimoun S, Droupy S. [Sexual pain disorders in females and males]. Prog Urol 2013; 23:761-70. [PMID: 23830271 DOI: 10.1016/j.purol.2013.01.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2013] [Revised: 01/26/2013] [Accepted: 01/28/2013] [Indexed: 01/23/2023]
Abstract
INTRODUCTION The occurrence of pain during sex is one of the most common complaints in gynecological and sexological practice but nonetheless one of the most difficult problems to deal with and treat effectively. METHODS A literature review was conducted on Medline considering the articles listed until January 2012 dealing with sexual pain in women and men. RESULTS The different descriptions of painful intercourse (dyspareunia, vestibulo-vulvodynies, vaginismus) are not separate entities but the result of the interaction of many factors including genital pain, emotional and behavioral responses to penetration, caresses, desire and excitement, in a context of possible organic pathology (infection, endometriosis, inflammatory or dermatological disease, morphological or pelvic abnormality, hormonal deficiency) sometimes associated with chronic pain phenomena self-sustained by neurogenic inflammation. The clinical expression of sexual pain is as variable as its causes are many. The etiological investigation is essential but should not omit the sexological context and the need for appropriate management. The neurogenic inflammation and hypersensitivity impose an algological approach associated to etiological and sexological treatment. CONCLUSION Chronic sexual pains, whether they are superficial or deep, can be the sign of organic or psycho-sexual (primary or secondary) disorders. The development of a "therapeutic program" helps patients, allows them to restore self-confidence and leads to the disappearance of the symptom in more than half cases.
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Affiliation(s)
- M Monforte
- Service de gynécologie-obstétrique et médecine de la reproduction, CHU Arnaud-de-Villeneuve, 34000 Montpellier, France
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[Prolapse surgery: vaginal mesh or sacropexy]. Urologe A 2011; 50:798-801. [PMID: 21725648 DOI: 10.1007/s00120-011-2608-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The systematic assessment of common therapy concepts for female genital prolapse has led to a better understanding of the functional and anatomical connections and given proof of the lasting effectiveness of traditional surgery. Besides the defined evidence-based therapy strategies in vaginal prolapse repair, vaginal meshes are being used with increasing frequency. The lack of reliable therapy recommendations for these methods sounds us a note of caution in their application and underlines the necessity of standardised performance in experienced departments.
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Current Opinion in Urology. Current world literature. Curr Opin Urol 2010; 20:533-8. [PMID: 20940575 DOI: 10.1097/mou.0b013e32834028bc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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