title: [Surgical treatment of genito-urinary prolapse by abdominal approach with promotofixation and setting of an anterior subvesical prosthesis combined with retropubic colpopexia: anatomical and functional results in 104 patients].
abstract: A homogeneous series of 104 patients with genito-urinary prolapse or urinary incontinence is reported. Surgical treatment combined promotofixation with (n = 45) or without (n = 59) subtotal hysterectomy, retropubic colpopexia and in certain cases posterior colpoperineorraphia with myorraphia of the levator ani (n = 28). Anatomic results were excellent for bladder and uterine ptosis. Moderate results were obtained for rectoceles and procedures involving the posterior perineum. A rectovaginal prosthesis or complete repair of the rectovaginal wall appeared to be required to improve results for rectoceles. Urine function was good for urinary incontinence: 91% success. Results depended on the pressure of the uretral closure. A complete urodynamic work-up is required prior to surgery in case of sphincter failure. Poor results were also related to excessive posterior traction which can open the cervico-uretral angle. Treatment of genito-urinary prolapse with promotofixation in combination with retropubic colpopexia is a reliable reproducible technique which gives excellent long-term results if excessive promontory traction is avoided and if, in certain cases, the rectovaginal wall is repaired or a prosthesis implanted when maximum uretral closure pressure is weak.
authors.affiliation: Service de Chirurgie Générale et Gynécologique, Hôpital des Diaconesses, Paris.
authors.forename: R
authors.initials: R
authors.lastname: Villet
authors.forename: E
authors.initials: E
authors.lastname: Mandron
authors.forename: D
authors.initials: D
authors.lastname: Salet-Lizee
authors.forename: M
authors.initials: M
authors.lastname: van den Akker
authors.forename: P
authors.initials: P
authors.lastname: Gadonneix
authors.forename: M
authors.initials: M
authors.lastname: Zafiropulo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D052776:Female Urogenital Diseases / Q000601:surgery*; D006801:Humans; D008722:Methods; D008875:Middle Aged; D011391:Prolapse; D012189:Retrospective Studies; D016896:Treatment Outcome
vernacular_title: Traitement chirurgcal des prolapsus génito-urinaires par voie abdominale avec promontofixation et mise en place d'une prothèse antérieure sous-vésicale associées à une colpopexie rétropubienne: résultats anatomiques et fonctionnels chez 104 patientes.