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Master Thesis

Chirurgie vaginale sans prothèse en cas de prolapsus des organes pelviens : un retour vers le futur ? : revue de la littérature

Abstract : Introduction. The recent removal of vaginal prostheses has allowed the return of techniques with native tissues. Objective. The objective of this work was to identify the different techniques of vaginal surgery using native tissues and to identify recent modifications allowing to improve the results. Material and methods: We performed a systematic review of the literature in the Pubmed database up to January 2021. The main outcomes were operative efficiency and morbidity. Results. We analyzed 76 articles of the 2570 found. Colpopexy or hysteropexy of the uterosacral (US) and sacrospinous ligaments were the main techniques used for apical prolapse without significant differences in efficacy. The double suspension of US and the combination of the plication with the US suspension are interesting changes. The anterior approach, bilateral suspension, the use of suturing aids are the main changes to the traditional sacrospinous fixation. Anterior colporrhaphy, paravaginal repair and plastron were the main surgeries for anterior prolapse. The choice of technique is adapted to the type of cystocele (apical, median, lateral). Conclusion. Given the disparity in operative morbidity and the results of autologous surgery, it seems important to conduct new studies with a higher level of evidence, randomized, with long-term follow-up analyzing the functional results rather than anatomical.
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Submitted on : Thursday, October 14, 2021 - 4:00:57 PM
Last modification on : Thursday, October 21, 2021 - 5:02:31 AM
Long-term archiving on: : Saturday, January 15, 2022 - 7:20:13 PM


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Mathilde Martin Lasnel. Chirurgie vaginale sans prothèse en cas de prolapsus des organes pelviens : un retour vers le futur ? : revue de la littérature. Médecine humaine et pathologie. 2021. ⟨dumas-03378457⟩



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