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[Laparoscopic sacrocolpopexy for pelvic organ prolapse: guidelines for clinical practice].

Prog Urol

July 2016

Service d'urologie, CHU Nantes, place Alexis-Ricordeau, 44093 Nantes Cedex 1, France.

Introduction: 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.

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A retrospective multicenter trial with participation of 7 large clinics of Moscow and Moscow Region has been performed to characterize complications after correction of genital prolapse with application of the PROLIFT system. The trial enrolled women with uterine and vaginal prolapse of stage II-IV by POP-Q classification. The women also had anatomic and functional defects of the adjacent organs.

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Genuine prolapse of the vaginal stump following total hysterectomy, which must be differentiated from the relatively frequent vaginal descent after hysterectomy usually not requiring additional surgery, is generally a rare positional anomaly of the female genitalia and is by no means easy to correct. This phenomenon requires special surgery to restore or preserve the ability to have intercourse. The article discusses the surgical techniques described in international literature which are suitable for correcting a prolapse of the vaginal stump.

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One of the most important principles of surgical correction of urinary stress incontinence is the restoration of the urethrovesical angle to its original anatomic position. A new variant of urethropexy, suspending the vaginal wall from the anterior rectus fascia, is presented. To accomplish this goal, a special ligature carrier needle was designed.

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