title: [Clinical practice guidelines: Synthesis of the guidelines for the surgical treatment of primary pelvic organ prolapse in women by the AFU, CNGOF, SIFUD-PP, SNFCP, and SCGP].
abstract: OBJECTIVE
  Develop guidelines for surgery for primary pelvic organ prolapse (POP).
  
  
  METHODS
  Literature review, establishment of levels of evidence, external review, 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 Colo-proctologie, 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).
authors: CHU de Nantes, 44000 Nantes, France.
authors: L
authors: L
authors: Le Normand
authors: CHRU de Lille, 59000 Lille, France.
authors: M
authors: M
authors: Cosson
authors: Hôpital Foch, 92150 Suresnes, France.
authors: F
authors: F
authors: Cour
authors: Hôpital Antoine-Béclère, 92140 Clamart, France.
authors: X
authors: X
authors: Deffieux
authors: Polyclinique Côte Basque Sud, 64500 Saint-Jean-de-Luz, France.
authors: L
authors: L
authors: Donon
authors: Centre hospitalier de La Rochelle, 17000 La Rochelle, France.
authors: P
authors: P
authors: Ferry
authors: CHU Carémeau, 30029 Nîmes, France.
authors: B
authors: B
authors: Fatton
authors: Hôpital Bichat, 75018 Paris, France.
authors: J-F
authors: JF
authors: Hermieu
authors: CHU de Tours, 37000 Tours, France.
authors: H
authors: H
authors: Marret
authors: CHU de Nantes, 44000 Nantes, France.
authors: G
authors: G
authors: Meurette
authors: Hôpital Saint-Louis, 75010 Paris, France.
authors: A
authors: A
authors: Cortesse
authors: CHU Carémeau, 30029 Nîmes, France.
authors: L
authors: L
authors: Wagner
authors: CHU de Poitiers, 2, rue de la Milètrie, 86000 Poitiers, France. Electronic address: xavier.fritel@univ-poitiers.fr.
authors: X
authors: X
authors: Fritel
mesh_terms: D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods / Q000592:standards*; D006801:Humans; D056887:Pelvic Organ Prolapse / Q000175:diagnosis / Q000601:surgery*; D017410:Practice Guidelines as Topic / Q000592:standards*
keywords: Femme; Genital prolapse; Guidelines; Prolapsus génital; Recommandations; Surgical treatment; Traitement chirurgical; Women