[Abdominal colposacroplexy for the treatment of vaginal vault prolapse with or without urinary stress incontinence].
OBJECTIVE
The aim of this study was to assess the factors of success in abdominal colposacropexy (CSP) procedures.


METHODS
We performed 271 consecutive CSP between 1986 and 1997 (mean age: 48.8 years +/- 11.1). We reviewed 217 patients (80.1%). Mean duration of follow-up was 5.5 years (1-136 months). We performed: 18 CSP with Goretex mesh, 3 with resorbable mesh and 196 with Mersilene; 179 CSP with posterior colporraphy and 38 without; 208 CSP with culdoplasty (Moschowitz's procedure) and 9 without; 182 CSP with anterior and posterior meshes, 26 with posterior mesh only and 9 with anterior mesh only.


RESULTS
97.7% (212/217) of patients were cured for prolapse. 58% (125/217) had urinary stress incontinence totally cured and 82% (178/217) had urinary stress incontinence improved. Rejected grafts were 16.7% (3/18) with Goretex mesh and 1.1% with Mersilene mesh (p = 0.004). Recurrent prolapses were 1.1% (2/196) with CSP with posterior colporrhaphy and 7.9% (3/38) in CSP without (p = 0.009; OR = 0.14, CI = 0.02-0.86); 4/208 with CSP with culdoplasty and 1/9 with CSP without (p = 0.04; OR = 0.17, CI = 0.02-1.58). Recurrent stress incontinence was observed in 4/9 cases with CSP with anterior mesh only and 28/182 with CSP with anterior and posterior meshes (p = 0.03; OR = 0.34, CI = 0.12-0.97).


CONCLUSIONS
CSP must use anterior and posterior Mersilene mesh. The CSP must be systematically combined with posterior colporraphy and culdoplasty (Moschcowitz's procedure).
Occelli
B
B
Clinique de Gynécologie-Obstétrique et Néonatologie, Hôpital Jeanne-de-Flandre, CHRU Lille.
Narducci
F
F
Cosson
M
M
Ego
A
A
Decocq
J
J
Querleu
D
D
Crépin
G
G
D000328:Adult; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D012189:Retrospective Studies; D013526:Surgical Mesh; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000209:etiology / Q000601:surgery*; D014596:Uterine Prolapse / Q000601:surgery*
La promonto-fixation par voie abdominale dans la cure des prolapsus génitaux féminins avec ou sans incontinence urinaire. A propos de 271 cas.