Christie Rebahi1, Claire Cardaillac2, Michel Cosson3, Hervé Fernandez4, Jean-Francois Hermieu5, Jean-Philippe Estrade6, Norbert Winer2, Vincent Dochez2, Thibault Thubert7. 1. Service de gynécologie et d'obstétrique, Centre Hospitalier Universitaire de Brest, Brest, France. 2. Service de gynécologie obstétrique, Centre Hospitalier Universitaire de Nantes, Hotel Dieu, 38, boulevard Jean-Monnet, 44093, Nantes, France. 3. Service de chirurgie gynécologique de Lille, Hopital Jeanne De Flandre, Lille, France. 4. Département de gynécologie et d'obstétrique, AP-HP, GHU-Sud, Hôpital Bicêtre, Le Kremlin Bicêtre, France. 5. Service d'urologie, Hôpital Bichat Claude Bernard, Assistance Publique Hôpitaux de Paris, Université Paris-Diderot, 46, rue Henri Huchard, 75018, Paris, France. 6. Service de gynécologie obstétrique, Gyneco Marseille Saint-Giniez, Marseille, France. 7. Service de gynécologie obstétrique, Centre Hospitalier Universitaire de Nantes, Hotel Dieu, 38, boulevard Jean-Monnet, 44093, Nantes, France. thibault.tubert@chu-nantes.fr.
Abstract
INTRODUCTION AND HYPOTHESIS: Sacropexy is a reference surgical treatment for pelvic organ prolapse in women. The great variability in surgical techniques for this procedure is a source of bias that complicates analysis of the results of trials assessing it. Using the French guidelines issued in 2016 by the SCGP, AFU, SIFUD-PP, and CNGOF as a reference, we sought to inventory the surgical practices of the surgeons who perform these procedures. METHODS: In November 2018, a questionnaire about the technical aspects of this procedure was distributed by email to the French physicians performing it. It was distributed to members of several professional societies (CNGOF, SCGP, and SIFUD) and to gynecologists practicing in clinics owned by the ELSAN group. RESULTS: Of the 273 responders, 92% reported that they perform most operations laparoscopically. Overall, 83% of gynecologic surgeons used polypropylene prostheses (mesh); 38% routinely placed a posterior mesh, while the rest did so only in cases of clinical rectocele with anorectal symptoms. A concomitant hysterectomy was performed by 51% of respondents when the uterus was bulky and/or associated with substantial uterine prolapse. Finally, half the surgeons suggested the placement of a suburethral sling for women with stress urinary incontinence. CONCLUSIONS: Although practices are largely consistent with the most recent guidelines, surgical techniques vary widely between surgeons, both in France and internationally.
INTRODUCTION AND HYPOTHESIS: Sacropexy is a reference surgical treatment for pelvic organ prolapse in women. The great variability in surgical techniques for this procedure is a source of bias that complicates analysis of the results of trials assessing it. Using the French guidelines issued in 2016 by the SCGP, AFU, SIFUD-PP, and CNGOF as a reference, we sought to inventory the surgical practices of the surgeons who perform these procedures. METHODS: In November 2018, a questionnaire about the technical aspects of this procedure was distributed by email to the French physicians performing it. It was distributed to members of several professional societies (CNGOF, SCGP, and SIFUD) and to gynecologists practicing in clinics owned by the ELSAN group. RESULTS: Of the 273 responders, 92% reported that they perform most operations laparoscopically. Overall, 83% of gynecologic surgeons used polypropylene prostheses (mesh); 38% routinely placed a posterior mesh, while the rest did so only in cases of clinical rectocele with anorectal symptoms. A concomitant hysterectomy was performed by 51% of respondents when the uterus was bulky and/or associated with substantial uterine prolapse. Finally, half the surgeons suggested the placement of a suburethral sling for women with stress urinary incontinence. CONCLUSIONS: Although practices are largely consistent with the most recent guidelines, surgical techniques vary widely between surgeons, both in France and internationally.
Entities:
Keywords:
Laparoscopic; Minimally invasive; Pelvic organ prolapse; Sacrocolpohysteropexy; Sacrocolpopexy; Sacrohysteropexy
Authors: Marine Lallemant; A T M Grob; M Puyraveau; M A G Perik; A H H Alhafidh; M Cosson; R Ramanah Journal: Sci Rep Date: 2022-09-29 Impact factor: 4.996