[Surgical abdominal access for prolapse using a Vicryl composite lattice. Preliminary study].
OBJECTIVE
Promontory fixation is a reliable technique for genitourinary prolapsus. Results obtained with Mersurtures are good, but infectious episodes have been described and the fixation is rigid. The pelvic organs loose their mobility with possible functional impairment. To avoid these problems, we tested a composite implant composed of 60% absorbable polyglactine 910 (Vicryl) and 40% non-absorbable terephthalic polyester (Dacron).


METHODS
A series of 32 patients with genito-urinary prolapsus were treated by one operator using the new material. Promontory fixation was performed in all cases, with at least one implant. The patients were followed for mean 24.2 months for evaluation of tolerance to the new material and the functional impact. These parameters were compared retrospectively with former experience with Mersutures.


RESULTS
The new material was perfectly tolerated and no infectious complication was observed. The anatomic results were identical to those obtained with the Mersutures, giving 93.4% good anatomic results, 68% cure rate for urinary incontinence and 20% major improvement in urinary incontinence. It was difficult to analyse results for sexual activity and digestive tract function.


CONCLUSIONS
The Vicryl composite is useful for promontory fixation in patients with prolapsus. This material which reduces the amount of inert material remaining in the form of a thin lattice of highly flexible Dacron, should be tested prospectively to determine the functional benefit of prolapsus care.
Villet
R
R
Service de Chirurgie Générale et Gynécologique, Hôpital des Diaconesses, Paris.
van den Akker
M
M
Salet-Lizee
D
D
Bastide
N
N
D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D011093:Polyethylene Terephthalates; D011098:Polyglactin 910; D011391:Prolapse; D012002:Rectal Diseases / Q000601:surgery*; D012189:Retrospective Studies; D013526:Surgical Mesh; D016896:Treatment Outcome; D001745:Urinary Bladder Diseases / Q000601:surgery*; D014596:Uterine Prolapse / Q000601:surgery*
D011093:Polyethylene Terephthalates; C025539:Lavsan; D011098:Polyglactin 910
Cure de prolapsus par voie abdominale à l'aide d'un treillis de Vicryl composite. Etude préliminaire.