Long-term functional stability of sacrospinous ligament-fixation repair of pelvic organ prolapse.

The objective of this study was to evaluate the variation over 5 years of functional discomfort associated with pelvic organ prolapse (POP) repaired by sacrospinous ligament fixation (SLF). A total of 178 women who had undergone SLF from 1992 to 2001. In 2002 and 2008, patients were sent a questionnaire including the pelvic floor distress inventory (PFDI-20); 79 responded and comparison of those data served to evaluate subjective signs at 5 years.

[Surgical treatment of female urinary stress incontinence].

Since the description of the sub urethral technique for genuine stress incontinence all the others have been abandoned. The surgical indications have not changed and are related to the poor quality of life of the patient induced by stress incontinence. A careful clinical examination and a pre operative urodynamique investigation should prevent from the failures due to a wrong indication.

[Vaginal vault fixation and reinforcement of the rectovaginal septum technique for the treatment of vault prolapse associated or not with rectocele].

The most important current concept in therapeutic management of female genital prolapse is the use of non absorbable prosthesis through a vaginal approach. The application of these surgical techniques to repair prolapse aims to restore the anatomic position of the pelvis, while preserving urinary, bowel and sexual functions. Since 2005, we use the Apogee® prosthesis for the treatment of both the vault prolapse and associated posterior colpocele.

[Pelvic floor disorders four years after first delivery: a comparative study of restrictive versus systematic episiotomy].

Objective: To compare two policies for episiotomy: restrictive and systematic.

Patients And Methods: It is a quasi-randomised comparative study between two French university hospitals with contrasting episiotomy policies: one using it restrictively and the second routinely. Population included 774 nulliparous women delivered during 1996 of a singleton in cephalic presentation at a term of 37-41 weeks.

Circumstances of leakage related to low urethral closure pressure.

Purpose: We determined whether urinary leakage in some circumstances is associated with intrinsic sphincter deficiency, defined by a low maximum urethral closure pressure of 30 cm H(2)O or less, in women presenting for urinary incontinence.

Materials And Methods: We retrospective analyzed the records of 100 consecutive women who underwent complete urodynamic evaluations for complaints of urinary leakage.

Results: Logistic regression adjusted for age showed that leakage while running or during physical exertion, leakage while walking and leakage with no obvious reason were associated with intrinsic sphincter deficiency, while leakage upon coughing or sneezing was not.