[Treatment of genital prolapse in young women: sacrohysteropexy or vaginal route?].
Even if genital prolapse does particularly affect the elder woman, we often have to face a surgical demand with conservation of the uterus from a patient less than 50 years. Before making the decision of treating a non life-threatening symptom by a specific surgical technique, it is important to ask who should be operated and when. Then, the route of the surgery has to be chosen considering that the woman wants to preserve her fertility. In the past decade, some surgical acts, like the sacrohysteropexy, were known as having poorer results if the women got pregnant. Thus, if there was a persistent childbearing desire, more interventions allowing pregnancy (like the Manchester's or the Richardson's procedures) were preferred. Nowadays, the sacrohysteropexy is considered as the gold standard technique, but one question is coming out: could we substitute this traditional surgery by a vaginal repair with meshes? Despite the big diversity of the so-called "sacrohysteropexy", we think that it remains the first choice technique to cure a young woman. Vaginal meshes have too high a rate of morbidity (especially on sexual activity) to be considered as the best surgical treatment. But this question could probably find another answer in the future, when all the studies about the component of the meshes will be finished.
Delarue
E
E
Pôle de chirurgie gynécologique, clinique de gynécologie, obstétrique et néonatologie, hôpital Jeanne-de-Flandre, université Lille-II, CHRU de Lille, 2, avenue Oscar-Lambret, 59037 Lille cedex, France.
Collinet
P
P
Sabban
F
F
Lucot
J-P
JP
Cosson
M
M
D005260:Female; D005298:Fertility; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000453:epidemiology; D011788:Quality of Life; D012725:Sexual Behavior / Q000502:physiology*; D013526:Surgical Mesh / Q000009:adverse effects*; D016896:Treatment Outcome; D014596:Uterine Prolapse / Q000601:surgery*