[Clinical practice guidelines: Summary of recommendations for first surgical treatment of female pelvic organ prolapse by 5 French academic societies: AFU, CNGOF, SIFUD-PP, SNFCP, and SCGP].
OBJECTIVE
Providing clinical practice guidelines for first surgical treatment of female pelvic organ prolapse.


METHODS
Systematic literature review, level of evidence rating, external proofreading, and grading of recommendations by 5 French academic societies: Association française d'urologie, Collège national des gynécologues et obstétriciens français, Société interdisciplinaire d'urodynamique et de pelvi-périnéologie, Société nationale française de coloproctologie, and Société de chirurgie gynécologique et pelvienne.


RESULTS
It is useful to evaluate symptoms, their impact, women's expectations, and to describe the prolapse prior to surgery (Grade C). In the absence of any spontaneous or occult urinary sign, there is no reason to perform urodynamics (Grade C). When a sacrocolpopexy is indicated, laparoscopy is recommended (Grade B). A bowel preparation before vaginal (Grade B) or abdominal surgery (Grade C) is not recommended. There is no argument to systematically use a rectovaginal mesh to prevent rectocele (Grade C). The use of a vesicovaginal mesh by vaginal route should be discussed taking into account an uncertain long-term risk-benefit ratio (Grade B). Levator myorrhaphy is not recommended as a first-line rectocele treatment (Grade C). There is no indication for a vaginal mesh as a first-line rectocele treatment (Grade C). There is no reason to systematically perform a hysterectomy during prolapse repair (Grade C). It is possible to not treat stress incontinence at the time of prolapse repair, if the woman is advised of the possibility of a 2-step surgical treatment (Grade C). Clinical practice guidelines. © 2016 Published by Elsevier Masson SAS.
Service urologie, CHU Nantes, place Alexis-Ricordeau, 44093 Nantes Cedex 1, France. Electronic address: loic.lenormand@chu-nantes.fr.
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L
Le Normand
Service de gynécologie obstétrique, CHRU Lille, rue Eugène-Avinée, 59037 Lille Cedex, France.
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M
Cosson
Service d'urologie, hôpital Foch, 40, rue Worth, 92150 Suresnes, France.
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F
Cour
Service de gynécologie obstétrique, hôpital Antoine-Béclère, 157, rue de la Porte-de-Trivaux, 92140 Clamart, France.
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Deffieux
Polyclinique Côte-Basque-Sud, 7, rue Léonce-Goyetche, 64500 Saint-Jean-de-Luz, France.
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L
Donon
Service de gynécologie obstétrique, CH La Rochelle, rue du Docteur-Scweitzer, 17000 La Rochelle, France.
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P
Ferry
Service de gynécologie, CHRU Carémeau, rue du Professeur-Debré, 30029 Nîmes cedex 9, France.
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B
Fatton
Service d'urologie, hôpital Bichat, AP-HP, 46, rue Henri-Huchard, 75018 Paris, France.
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JF
Hermieu
Service de gynécologie, hôpital Bretonneau, 2, boulevard Tonnellé, 37044 Tours Cedex, France.
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H
Marret
Service de chirurgie digestive et endocrinienne, CHU Nantes, place Alexis-Ricordeau, 44093 Nantes Cedex 1, France.
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G
Meurette
Service d'urologie, hôpital Saint-Louis, 1 avenue Claude Vellefaux, Paris, France.
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A
Cortesse
Service d'urologie, CHU de Nîmes, place du Professeur-Debré, 30065 Nîmes Cedex 9, France.
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Wagner
Service de gynécologie obstétrique et médecine de la reproduction, CHU de Poitiers, Poitiers, France.
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Fritel
D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods / Q000592:standards*; D006801:Humans; D056887:Pelvic Organ Prolapse / Q000601:surgery*
Femme; Genital prolapse; Guidelines; Prolapsus génital; Recommandations; Surgical treatment; Traitement chirurgical; Women