Douleurs postopératoires après cure de prolapsus génital par voie vaginale avec ou sans renfort prothétique

Niro, J.; Philippe, A.-C.; Jaffeux, P.; Amblard, J.; Vélémir, L.; Savary, D.; Jacquetin, B.; Fatton, B.

doi:10.1016/j.gyobfe.2010.09.007

Cited by 8 publications

(4 citation statements)

References 20 publications

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“…When they complicate an exposure of the mesh, more than half are treated medically. If infection persists beyond 2 months excision of the implant is required [34] . The prosthetic infection rate is 0–8% with or without previous exposure of the mesh [35] .…”

Section: Discussionmentioning

confidence: 99%

3-year results of transvaginal cystocele repair with transobturator four-arm mesh: A prospective study of 105 patients

Kdous¹,

Zhioua²

2014

Arab Journal of Urology

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ObjectivesTo evaluate the long-term efficacy and safety of transobturator four-arm mesh for treating cystoceles.Patients and methodsIn 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.ResultsAt 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.ConclusionsIf 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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Section: Discussionmentioning

confidence: 99%

3-year results of transvaginal cystocele repair with transobturator four-arm mesh: A prospective study of 105 patients

Kdous¹,

Zhioua²

2014

Arab Journal of Urology

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“…In recent years, nonabsorbable mesh has been used in pelvic prolapse surgery. This technique is associated with various complications in the vagina, bladder, and intestine [ 30 ]. A subset of these patients develops chronic pain, possibly due to muscle and nerve irritation which may be caused by mesh implantation [ 31 ].…”

Section: Discussionmentioning

confidence: 99%

“…Meanwhile, the same history is found in 66.66% of GA failure, but 32.83% of GB failure ( p = 0.0204). This correlation is highly relevant given the intrinsic benefit of BFB for women suffering from UI [ 30 ]. In women who have already undergone UI surgery, have a cystocele and undergo surgery only for cystocele repair, any possible benefit of BFB for voiding dynamics is lost.…”

Section: Discussionmentioning

confidence: 99%

Effects on Health-Related Quality of Life of Biofeedback Physiotherapy of the Pelvic Floor as an Adjunctive Treatment Following Surgical Repair of Cystocele

Borrego-Jimenez

Padilla-Fernández

Valverde-Martínez

et al. 2020

JCM

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Objectives: to demonstrate the benefits of physiotherapy (PT) with pelvic floor biofeedback (BFB) in improving health-related quality of life when used as a complementary therapy after surgical treatment of cystocele, in cases in which perineal pain or discomfort persists. Materials and methods: prospective observational study in 226 women who received complementary therapy after surgical treatment of cystocele due to persistent perineal discomfort or pain. Groups: GA (n = 78): women treated with 25 mg of oral pregabalin every 12 h plus BFB, consisting of 20 once-weekly therapy sessions, each 20 min long, with perineal pregelled surface electrodes connected to a screen which provides visual feedback; GB (n = 148): women treated with oral pregabalin 25 mg every 12 h without BFB. Variables: age, body mass index (BMI), time since onset of cystocele prior to surgery (TO), SF-36 health-related quality of life survey score, diseases and concomitant health conditions, follow-up time, success, or failure of postsurgical treatment. Results: average age 67.88 years (SD 12.33, 30–88), with no difference between GA and GB. Average body mass index (BMI) 27.08 (SD 0.45, 18.74–46.22), with no difference between GA and GB. Time since onset of cystocele prior to surgery (TO) was 6.61 years (SD 0.6), with no difference between GA and GB. Pretreatment SF-36 score was lower in GA success than GB success. Treatment was successful in 141 (63.20%) women and failed in 82 (36.80%). PT and age were the main predictors of success, and the least important were pretreatment SF-36 and the time elapsed after the intervention. In GA, 63 women (80.80%) showed improvement while 15 (19.20%) did not. Age was the main predictor of treatment success, while the least important was BMI. In GB, 78 women (53.80%) showed improvement while 67 (46.20%) did not improve. The main predictor was time since cystocele onset prior to surgery, while the least important was age. The odds ratio (OR) of improving quality of life for each unit increase in SF-36 was 11.5% (OR = 0.115) in all patients, with no difference between success and failure; in GA it was 23.80% (OR = 0.238), with a difference between success and failure; in GB it was 11.11% (OR = 0.111), with no difference between success and failure. GA and GB success had more history of eutocic delivery. GA success had more rUTI. GB success and GA failure both had more history of UI corrective surgery. The “failure” outcome had a higher number of patients with more than two concomitant pathological conditions. Conclusions: BFB as an adjunctive treatment improves quality of life in women suffering from persistent discomfort after surgery for cystocele. Young women who meet the criteria for recurrent urinary tract infection or who have a history of eutocic delivery show greater improvement. Body mass index does not influence response to treatment, while the presence of more than two concomitant conditions indicates a poor prognosis for improving quality of life.

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“…dans une méta-analyse de 110 études et plus de 18 000 patientes [8] ; c'est aussi la moins grave, car même si le traitement local guérit seulement une patiente sur cinq, la chirurgie qui se limite à une exérèse très limitée avec parage vaginal est réalisée souvent au cabinet aux États-Unis, avec un taux de réintervention au bloc allant de 3 à 5,8 % ; • la douleur est la plus préoccupante, mais est-elle si spécifique à la prothèse ? Dans un travail prospectif à Clermont-Ferrand, nous n'avons pas trouvé de différence avec ou sans prothèse en utilisant en prospectif une EVA de la douleur à trois mois postopératoires [9]. Attention, les patientes « algiques » en préopératoire sont très certainement de mauvaises candidates au renforcement prothétique .…”

Section: The Meshes Warunclassified

La guerre des mèches !

Jacquetin

Cosson

2011

Journal de Gynécologie Obstétrique et Biologie de la Reproducti

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Douleurs postopératoires après cure de prolapsus génital par voie vaginale avec ou sans renfort prothétique

Cited by 8 publications

References 20 publications

3-year results of transvaginal cystocele repair with transobturator four-arm mesh: A prospective study of 105 patients

3-year results of transvaginal cystocele repair with transobturator four-arm mesh: A prospective study of 105 patients

Effects on Health-Related Quality of Life of Biofeedback Physiotherapy of the Pelvic Floor as an Adjunctive Treatment Following Surgical Repair of Cystocele

La guerre des mèches !

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