geoscience.net logo
+ Resolve Article
+ Follow Us
Follow on FacebookFollow on Facebook
Follow on TwitterFollow on Twitter

+ Translate
+ Subscribe to Site Feed
GeoScience Most Shared ContentMost Shared Content

Laparoscopic sacrocolpopexy for pelvic organ prolapse: guidelines for clinical practice


, : Laparoscopic sacrocolpopexy for pelvic organ prolapse: guidelines for clinical practice. Progres en Urologie 26 Suppl 1(): S27-S37

Open sacrocolpopexy have demonstrated its efficiency in surgical treatment of pelvic organ prolapse with an important backward on a large number of patients. Laparoscopic sacrocolpopexy reproduced the same surgical technique with reduced morbidity and may benefits from the recent development of robotic. Numerous technical variants have been developped around the original procedure but results seems not ever equivalent. Our objectives are to establish practical recommendations issues from the data of the litterature on the various technical aspects of this technique. This work leans on an exhaustive lecture of the literature concerning meta analyses, randomized tries, registers, controlled studies and the largest non controlled studies published on the subject. Recommendations were developed by a multidisciplinary workgroup then reread and amended by an also multidisciplinary group of proofreaders (urologists, gynecologists, gastroenterologists and surgeons). The methodology follows at best the recommendations of the HAS with a scientific argument for every question (accompanied with the level of proof, NP) and the recommendations, the officers (In, B, C and agreement of experts) and validated at the end of the phase of review. Surgical treatment of uro-genital prolapse by abdominal route classically associated hystero and anterior vaginopexy on the sacral ligament with a synthethic mesh. There are no argument to systematically associated a posterior vaginopexy to prevent secondary rectocele (level C). The consensual indication of laparoscopic rectopexy is represented by symptomatic rectal prolapse, the anatomical and functional results of which are the best estimated (level C). The surgical treatment of rectocele, elytrocele and enterocele with a posterior vaginopexy is not well estimated (level 3). Thus, it is not possible to conclude on the results of a posterior vaginal fixation with a mesh in these indications (AP). In the absence of colpocèle, the interest brought by the posterior vaginal mesh is not established (level 3). There is no comparative studies which allows to conclude on the type and mode of fixation of the prostheses of sacrocolpopexy. We would only report the most common practices without other conclusion. The anterior mesh is usually fixed upper on the anterior part of uterus cervix and lower on the anterior vaginal wall. These fixations are most of the time made by suture and on the promontory with non absorbable suture. The great majority of the authors recommend to make a peritonisation of prostheses to limit the risk of post-operative occlusion. It is now recommended to use only 2 kind of not absorbable prostheses: type I (macroporous polypropylene) or type III (polyester) and not to use any more prostheses type II (PTFE, Silicone) (level C) because of a high rate of mesh erosion: PTFE (9 %) or Silicone (19%) (level 3). Biological prostheses are no more recommended, because of short and medium-term lower anatomical results (level B). Anatomical and functional results are not stastistically differents between laparotomy and coelioscopy (NP1) but the comparison of tong-term results between both ways is not yet established. Coelioscopy allows significant reduction of blood losses, hospital stay and return to normal activity (level 1). Furthemore, there is a higher level of post-operative complications in laparotomy (level 1). When sacrocolpopexy is indicated, coelioscopy is thus recommended (level B). During coelioscopic sacrocolpopexy, anatomical and functional result have not shown any significance difference when using or no a robotics assistance but real randomised studies does not exist (level 2). In comparison to coelioscopy, robotic seems not to improve post-operative consequences and not to decrease the rate of complications of sacrocolpopexy (level 3). Robotic assistance cannot be yet recommended when a coelioscopic sacrocolpopexy is indicated (rank B). Sacrocolpopexy using not absorbable meshes allows to cure pelvic organ prolapses with very good results with few complications in terms of prothetic exposure and infection and thus is now considered as the referent prothetic surgical technique in this indication. Thus, it seems very important to establish clear recommendations on the numerous operating technical variants which developed around the original technique. © 2016 Published by Elsevier Masson SAS.

US$19.90

PMID: 27595624

DOI: 10.1016/S1166-7087(16)30426-2


Other references

Brun, A.; Chappuis, G., 1976: Breeding virus-free cats and dogs. The procedure is outlined for breeding dogs and cats free from specific viruses for research purposes. The viruses from which the animals must be free are enumerated. Particulars are given of the design and equipment of the special breeding compou...

McCaskie S.L.; Chang C.C.; Chantome R.G., 1993: Scour analysis for bridges over Missouri and Mississippi rivers. Hydraulic Engineering: Proceedings of the National Conference on Hydraulic Engineering 1993: 398-603

Burda, B.U.; Holmer, H.K.; Norris, S.L., 2016: Limitations of A Measurement Tool to Assess Systematic Reviews (AMSTAR) and suggestions for improvement. A Measurement Tool to Assess Systematic Reviews (AMSTAR) is a commonly used tool to assess the quality of systematic reviews; however, modifications are needed to improve its usability, reliability, and validity. In this commentary, we summarize o...

Sarapulova, O.; Sherstiuk, V.; Shvalagin, V.; Kukhta, A., 2017: Erratum to: Photonics and Nanophotonics and Information and Communication Technologies in Modern Food Packaging. Nanoscale Research Letters 12(1): 188-188

Augusto, O.; Lopes D.M.nezes, S.; Linares, E.; Romero, N.; Radi, R.; Denicola, A., 2002: EPR detection of glutathiyl and hemoglobin-cysteinyl radicals during the interaction of peroxynitrite with human erythrocytes. Peroxynitrite, which is formed by the fast reaction between nitric oxide and superoxide anion, has been receiving increasing attention as a mediator of human diseases. An initial controversy about the possibility of free radical production from pe...

Rosenthal, M.Zachary.; Cheavens, J.S.; Lynch, T.R.; Follette, V., 2006: Thought suppression mediates the relationship between negative mood and PTSD in sexually assaulted women. Sexually victimized individuals often report chronic attempts to avoid unpleasant internal experiences (e.g., thoughts, emotions, memories) as a means of affect regulation. The aim of this study was to expand upon previous findings by examining th...

Capovilla, M.; Brandt, M.; Botas, J., 1994: Direct regulation of decapentaplegic by Ultrabithorax and its role in Drosophila midgut morphogenesis. Drosophila homeotic genes encode transcription factors thought to control segmental identity by regulating expression of largely unknown target genes. The formation of the second midgut constriction requires the Ultrabithorax (Ubx) and abdominal-A...

Hudgins, P.M.; Bond, G.H., 1979: Reversal of vanadate inhibition of sodium potassium atpase ec 3.6.1.3 by catecholamines. Vanadate (VO3-4) is a potent inhibitor of NaK-ATPase (EC 3.6.1.3), and this inhibition can be reversed by catecholamines. In the absence of vanadate, catecholamines do not significantly alter NaK-ATPase activity. Present findings are consistent wi...

Mathews, L.S.; Norstedt, G.; Palmiter, R.D., 1986: Regulation of insulin-like growth factor I gene expression by growth hormone. Recombinant clones containing exon 3 of the insulin-like growth factor I (IGF-I) gene were isolated from a mouse genomic library. These sequences were used to generate an RNA probe, which was used in a solution hybridization assay to quantitate IG...

Petersen, S.Beck.; Lovmand, J.Mangor.; Honoré, L.; Jeppesen, C.Bekker.; Pridal, L.; Skyggebjerg, O., 2010: Comparison of a luminescent oxygen channeling immunoassay and an ELISA for detecting insulin aspart in human serum. The study was a comparison between a Luminescent Oxygen Channeling Immunoassay (LOCI) and an enzyme-linked immunosorbent assay (ELISA) for quantification of Insulin Aspart (IAsp) in human serum. The advantage of LOCI compared to ELISA is reduced w...