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Comparaison des complications et des résultats fonctionnels après double promontofixation cœlioscopique par agrafage ou suture de la prothèse postérieure pour la cure du prolapsus génital

Comparison of morbidity and functional results of suture or staplin of the posterior mesh during laparoscopic promontofixation in the cure of genital prolapse

  • Article Original / Original Article
  • Published:
Pelvi-périnéologie

Résumé

But de l’étude|

Comparaison de la morbidité et des résultats fonctionnels de la double promontofixation cœlioscopique pour la cure du prolapsus génital en fonction du mode de fixation de la prothèse postérieure.

Patientes et méthode|

De mars 2001 à janvier 2009, 86 patientes présentant un prolapsus génital de grade supérieur ou égal à 2 (POP-Q classification) ont été opérées par cœlioscopie, dont 47 avec fixation de prothèse postérieure par suture (groupe fils) et 39 par agrafage (groupe agrafes). Les complications per-, postopératoires et la satisfaction des patientes ont été évaluées.

Résultats|

À l’exception de la parité qui était plus élevée dans le groupe agrafes, il n’existait pas de différence entre les groupes pour l’âge, les antécédents chirurgicaux et le stade du prolapsus. La durée opératoire était plus courte dans le groupe agrafes (p = 0,005). Il n’existait pas de différence du taux de complications per- et postopératoires entre les groupes. La durée d’hospitalisation était plus courte pour le groupe agrafes (p = 0,007). Il n’existait pas de différence du taux de symptômes de novo, des résultats fonctionnels et de la satisfaction entre les groupes.

Conclusion|

Nos résultats suggèrent que l’agrafage de la prothèse postérieure dans la promontofixation cœlioscopique offre une diminution de la durée opératoire et de l’hospitalisation par rapport à la suture sans différence des résultats fonctionnels.

Abstract

Objective|

To compare the morbidity and functional results after laparoscopic promontofixation for the cure of genital prolapse according to the type of fixation of the posterior mesh.

Patients and method|

From March 2001 to January 2009, 89 patients with genital prolapse of grade 2 (POP-Q classification) were operated on by laparoscopy including 47 patients with the suture of the posterior mesh (group suture) and 39 patients with stapling (group staples). Complications per-, postoperative, and patient satisfaction were assessed.

Results|

Except for the mean parity that was higher in the group staples, no difference was found between the groups in the mean age, prior surgery, and genital prolapse stage. Operating time was shorter in the group staples (p = 0.005). No difference was found between the groups in the rate of intra- and postoperative complications. Hospital stay was shorter for the group staples (p = 0.007). No difference between the groups was found in de novo symptoms and satisfaction, as well as in functional results.

Conclusion|

Our results support that stapling of the posterior mesh for the laparoscopic promontofixation is associated with decrease in operating time and hospital stay compared to the suture without affecting functional results.

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Authors and Affiliations

  1. Service de gynécologie-obstétrique, hôpital Tenon, Assistance publique des Hôpitaux de Paris, université Pierre-et-Marie-Curie Paris-VI, 4, rue de la Chine, F-75020, Paris, France

    C. Bui, M. Ballester, E. Chéreau, E. Guillo & E. Daraï

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  1. C. Bui
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  2. M. Ballester
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  3. E. Chéreau
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  4. E. Guillo
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  5. E. Daraï
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Correspondence to E. Daraï.

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Bui, C., Ballester, M., Chéreau, E. et al. Comparaison des complications et des résultats fonctionnels après double promontofixation cœlioscopique par agrafage ou suture de la prothèse postérieure pour la cure du prolapsus génital. Pelv Perineol 6, 134–139 (2011). https://doi.org/10.1007/s11608-010-0320-3

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  • DOI: https://doi.org/10.1007/s11608-010-0320-3

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