Quelle information délivrer à une patiente avant une chirurgie de prolapsus ?

Letouzey, V.; Fritel, Xavier; Pierre, Fabrice H.F.; Courtieu, C.; Marès, P.; Tayrac, Renaud de

doi:10.1016/j.gyobfe.2010.02.005

Cited by 1 publication

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“…Le prolapsus génital étant une pathologie fonctionnelle, le praticien a l'obligation de donner une information détaillée axée sur les risques fréquents et graves (décès ou invalidité), les bénéfices attendus, les conséquences fonctionnelles, les alternatives thérapeutiques et les conséquences de l'abstention thérapeutique. Les risques fréquents pourraient être définis par les complications survenant dans plus de 1% des cas [25]. Pour la chirurgie par voie abdominale (promontofixation), ces complications fréquentes sont les plaies vésicales (10%), les occlusions intestinales (4,6%), les complications hémorragiques (3,9%), les érosions vaginales (3,4%) et la constipation [26][27][28][29][30][31][32][33][34][35][36].…”

Section: Intérêt Des Autoquestionnairesunclassified

Evaluation Objective Des Symptomes : Et Information Des Patientes

Tayrac

Letouzey²,

Marès³

2013

LMJ

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Genital prolapse is a functional pathology presenting with numerous urinary, genito-sexual, and anorectal symptoms. These symptoms are responsible for an alteration of the quality of life, sometimes associated to a real anxiety-depressive syndrome. Because of these complex intricacies, the management of these disorders became multidisciplinary. Tools to measure the impact of prolapse symptoms on the quality of life became a necessity. Such instruments should allow a correlation of the functional symptomatology at the anatomic stage, raise a surgical indication based on the functional disturbance and evaluate the effectiveness and tolerance of the various therapeutic procedures. Two validated self-questionnaires in French (short versions of the Pelvic Floor Distress Inventory [PFDI-20] and the Pelvic Floor Impact Questionnaire [PFIQ-7]) are presently available. Moreover, the physician has the legal obligation to provide detailed presurgical information on frequent and severe hazards, expected benefits, functional consequences, therapeutic alternatives and the consequences of nonintervention. Before surgery takes place, the surgical approach, the benefit of using synthetic prostheses, the possibility of uterine and/or ovarian conservation, and some risky conditions such as smoking, obesity and estrogen deficiency should be discussed.

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