[Prosthetic restoration of the pelvic diaphragm in genital urinary prolapse surgery: transobturator and infracoccygeal hammock technique].
OBJECTIVE
To describe a surgical technique for genital prolapse via exclusive vaginal access using prosthetic materials. The original feature of this technique is based on the use of a monoprosthesis. This technique aims to reconstitute the ruptured pelvic diaphragm in full with a single mesh. To estimate feasibility and reproducibility of the technique.


METHODS
After reduction of the elements of prolapse, the intervention consists in positioning under these same elements a single and non-absorbable mesh with two transobturator expansions associated with an infracoccygeal sacropexy. No specific urinary procedure is performed. This process was applied to a preliminary series of 26 patients with Baden and Walker stage 3 and 4 genital prolapse, sometimes associated with urinary stress incontinence.


RESULTS
This technique successful in every case with full restitution. No intra-operative complication was observed. Short-term anatomical results were excellent. Urinary stress incontinence when present was corrected or clearly improved.


CONCLUSIONS
Transobturator and infracoccygeal hammock is a fast, solid and easily reproducible original surgical process, causing minimal post-operative discomfort. Indications are posthysterectomy complete prolapse and prolapse of the three floors in menopaused woman, from stage 2 with or without associated urinary stress incontinence. Success of this technique depends on good long-term tolerance of the new prosthetic materials used in female pelvic surgery.
Sergent
F
F
Clinique Gynécologique et Obstétricale, Pavillon Mère-Enfant, Hôpital Charles-Nicolle, 1, rue de Germont, 76031 Rouen Cedex. Fabrice.Sergent@chu-rouen.fr
Marpeau
L
L
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008875:Middle Aged; D017773:Pelvic Floor / Q000601:surgery*; D019736:Prostheses and Implants; D013526:Surgical Mesh; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000209:etiology / Q000601:surgery; D014596:Uterine Prolapse / Q000150:complications / Q000601:surgery*; D014621:Vagina / Q000601:surgery*
Renforcement prothétique du diaphragme pelvien dans la chirurgie des prolapsus génito-urinaires: technique du hamac transobturateur infracoccygien.