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National survey of surgical practices: Sacropexy in France in 2019

  • Original Article
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International Urogynecology Journal Aims and scope Submit manuscript

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.

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Abbreviations

AFU:

Association Française des Urologues

AUGS:

American UroGynecology Society

CEROG:

Committee for Ethics in Research in Obstetrics and Gynecology

CI:

Confidence interval

CNGOF:

National College of French Gynecologists and Obstetricians

EPIQ-35:

Epidemiology of Prolapse and Incontinence Questionnaire

ICI:

International Consultation on Incontinence

IUGA:

International UroGynecology Association

LE:

Level of Evidence

NS:

Not significant

OR:

Odds Ratio

PGI-I:

Patient Global Impression of Improvement

SCGP:

Society of Gynecologic and Pelvic surgery

SIFUD-PP:

Interdisciplinary French-speaking Society of Urodynamics and Pelvic Perineology

SUI:

stress urinary incontinence

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Acknowledgements

We would like to acknowledge all the scientific societies (SCGP, SIFUD-PP, CNGOF) and Elsan group for allowing us to distribute the survey to all its members.

Author information

Authors and Affiliations

  1. Service de gynécologie et d’obstétrique, Centre Hospitalier Universitaire de Brest, Brest, France

    Christie Rebahi

  2. Service de gynécologie obstétrique, Centre Hospitalier Universitaire de Nantes, Hotel Dieu, 38, boulevard Jean-Monnet, 44093, Nantes, France

    Claire Cardaillac, Norbert Winer, Vincent Dochez & Thibault Thubert

  3. Service de chirurgie gynécologique de Lille, Hopital Jeanne De Flandre, Lille, France

    Michel Cosson

  4. Département de gynécologie et d’obstétrique, AP-HP, GHU-Sud, Hôpital Bicêtre, Le Kremlin Bicêtre, France

    Hervé Fernandez

  5. Service d’urologie, Hôpital Bichat Claude Bernard, Assistance Publique Hôpitaux de Paris, Université Paris-Diderot, 46, rue Henri Huchard, 75018, Paris, France

    Jean-Francois Hermieu

  6. Service de gynécologie obstétrique, Gyneco Marseille Saint-Giniez, Marseille, France

    Jean-Philippe Estrade

Authors
  1. Christie Rebahi
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  2. Claire Cardaillac
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  3. Michel Cosson
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  4. Hervé Fernandez
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  5. Jean-Francois Hermieu
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  6. Jean-Philippe Estrade
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  7. Norbert Winer
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  8. Vincent Dochez
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  9. Thibault Thubert
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Contributions

Equally contributed to this work.

C Rebahi: Survey development, Management of data, Data analysis, Manuscript.

T Thubert: Survey development, Management of data, Data analysis, Manuscript writing.

C Cardaillac: Data collecting.

M Cosson: Survey development, Manuscript editing.

H Fernandez: Survey development, Manuscript editing.

JF Hermieu: Survey development, Manuscript editing.

JP Estrade: Survey development, Manuscript editing.

N Winer: Survey development.

V Dochez: Manuscript editing.

Corresponding author

Correspondence to Thibault Thubert.

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Congres presentation

This work was presented as an oral communication at the SIFUD-PP conference in La Rochelle, France (June 2019), and at the SCGP conference in Lille, France (September 2019)

Appendix 1: Survey

Appendix 1: Survey

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*: multiple answer questions (several responses are permitted).

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Rebahi, C., Cardaillac, C., Cosson, M. et al. National survey of surgical practices: Sacropexy in France in 2019. Int Urogynecol J 32, 975–991 (2021). https://doi.org/10.1007/s00192-020-04526-8

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  • DOI: https://doi.org/10.1007/s00192-020-04526-8

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