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Unilateral sacrospinous ligament fixation for treatment of genital prolapse

Chinese Medical Journal 2010年第15期123卷 1995-1998页

作者： PENG Ping ZHU Lan LANG Jing-he WANG Wen-yan SHI Hong-hui Department of Obstetrics and Gynecology Peking Union College Hospital Peking Union Medical College Chinese Academy of Medical Sciences Beijing 100730 China

Background genital prolapse affects 30% of middle-aged and older women and is becoming a major public health concern. Sacrospinous ligament fixation is an effective and safe procedure for vaginal vault prolaps with a low recurrence and complication rate. This study aimed to investigate the efficacy and safety of unilateral sacrospinous ligament fixation （SSLF） for the management of pelvic organ prolapse （POP）.Methods Forty patients with severe prolapse of pelvic organ undergoing unilateral SSLF were retrospectively studied.In this study, all patients were staged by the value of POP-Q. All procedures were performed by a senior physician. The characteristics of these patients and their immediate and short-term post-operative outcome were recorded. All patients were seen six weeks and six months after the surgery. The evaluation included standardized questionnaire and site-specific vaginal examination by one physician.Results The average operation time was 65-92 minutes. The average blood loss was 83-188 ml. The average hospitalization time was 6.1 days. The average cost was 5885 yuan. The average day of urethral catheter removal after the operation was 2.1 days. The incidence of postoperative morbidity was 17.1%. One （2.4%） patient had hematoma in the right pelvic. The mean length of postoperative follow-up for 35 patients was 13.1 months. The rate of follow-up was 87.5%. One （2.9%） patient showed recurrent vaginal vault prolapse six months after the surgery. The objective success rate of pelvic organ prolapse was 85% （34/40）. There was significant difference between the POP-Q of Aa, Ba, Ap, Bp,and D before and after operation （P 〈0.001 ）. Five （14.3%） patients complained lower back pain, gluteal pain or right groin pain. Three （8.6%） patients developed de novo stress incontinence. Vaginal disabsorbable sutures were found in three （8.6%） patients. One （2.9%） patient had de novo urge incontinence.Conclusions Unilateral SSLF was both cost and treatment effective management for severe pelvic organ prolapse,especially

关键词： unilateral sacrospinous ligament fixation genital prolapse complication

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Management of Two Cases of Spina Bifida and Neonatal genital prolapse at the University Hospital of Parakou and Review of the Literature

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Open Journal of Modern Neurosurgery 2022年第4期12卷 216-221页

作者： Kouassi Jean Marie Maurin Kisito Quenum Ayaovi Armel Hadonou Toyifia Eudoxie Bernice Quenum Hountondji Sophonie Dokpe Zachée Agbo Matine Balagoun Olatundji Holden Fatigba Service de Neurochirurgie du Centre hospitalo universitaire départemental/Borgou Alibori (CHUD/BA) Parakou Benin Service de chirurgie du Centre hospitalo universitaire départemental/Borgou Alibori (CHUD/BA) Parakou Benin Centre de prise en charge médicale intégrée des nourrissons et femmes enceintes atteints de la drépanocytose (CPMI-NFED) Parakou Benin

Spina bifida, or spinal dysraphism, is a malformative pathology related to an anomaly in the development of the nervous system, occurring during embryogenesis. The neural tube does not close properly around the 28th day of life and affects the development of the spinal column and spinal cord. Spina bifida is characterised by damage to the nervous system and will generate handicaps and damage of varying degrees: neurological motor, sensory, cognitive, genito-phincter (bladder and anorectal) deficits with consequences for the quality of life of these people. The literature describes the association between spinal dysraphism and genital prolapse. However, genital prolapse is an exceptional and rare entity in newborns. We report the observations of two newborns: the first case of a newborn born at term, at 7 days of age, who presented a prolapse of the uterine cervix in association with myelomeningocele, without any neuromuscular repercussions, and the second case of a newborn at 10 days of age, presenting with a lumbosacral spina bifida and a uterine prolapse. They benefited from conservative medical treatment characterised by manual reduction of the prolapse in both cases with a favourable evolution. In the case of spina bifida, a cure of myelomeningocele was performed surgically with simple postoperative course.

关键词： Spina Bifida genital prolapse Neonate Complications CHUD/BA

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Clinical and Therapeutic Aspects of genital prolapse at Hôpital du Mali about 100 Cases

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Open Journal of Obstetrics and Gynecology 2023年第1期13卷 121-132页

作者： Mamadou Bakary Coulibaly Mody Abdoulaye Camara Alassane Traoré Mamadou Keïta Bourama Kané Abdramane Togo Issa Ongoiba Kalba Tembiné Amadou Sidibé Baba Fané Ibrahima Tégueté Youssouf Traoré Gynecology Department of Hô pital du Mali Bamako Mali Medical Imaging Department of Hô pital du Mali Bamako Mali Referral Health Center of Commune VI of the District of Bamako Bamako Mali Pediatrics Department of Hô pital du Mali Bamako Mali Anesthesia and Intensive Care Unit Hô pital du Mali Bamako Mali Biomedical Department of Hô pital du Mali Bamako Mali Department of Gynecology Obstetrics UTH Gabriel Touré Bamako Mali

To study the epidemio-clinical aspects, and the therapeutic attitudes of genital prolapse (GP) in the gynecology department of Hôpital du Mali (HDM). This is a descriptive retro-prospective study over five (5) years from January 2015 to December 2019, conducted in the gynecology department of HDM. We had collected 100 cases of GP out of 989 surgeries, with a frequency of 9.89%. The age group of 60 years and over accounted for 33% of our patients, with a mean age of 50 years. Multiparous were the most affected (89%). The notion of obstructed labor was observed in 52% of patients. The most found reason for consultation was the feeling of lump in a vagina, with 65%. Grade III according to BADEN-WALKER classification system (BWCS) concerned 72% of our patients. Triple perineal surgery and hysterectomy involved 56% of our patients. Spinal anesthesia was performed in 96% of cases. Per and postoperative complications were dominated by urinary retention in 4% and by infection of the surgical site in 2%. The average hospital stay was 3.2 days. We recorded 88% of satisfied patients after the intervention. No deaths were recorded during the study. The management of genital prolapse remains essentially surgical;it requires a semiological analysis and a mastery of the surgical technique.

关键词： genital prolapse Therapeutic Attitudes Hôpital du Mali

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Vaginal Cystocele Cure at Bouake University Hospital (Chu): Anatomical and Functional Results

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Open Journal of Urology 2023年第9期13卷 337-344页

作者： Kouassi Patrice Avion Nykan Anne Felicite Kramo N’diamoi Akassimadou Freddy Zouan Venance Alloka Sadia Kamara Koffi Dje Urology Department Bouaké University Hospital (CHU) Bouaké Ivory Coast Urology Department Ccody University Hospital (CHU) Abidjan Ivory Coast

Background: Cystocele is an anatomical form of pelvic organ prolapse. It involves herniation of the bladder through the anterior wall of the vagina. Objectives: To report the anatomical and functional results of vaginal cure of cystocele in five cases. Patients and methods: A cross-sectional descriptive study of five patients presenting with a cystocele between January 2021 and December 2022 at the Urology Department of the Bouaké University Hospital (Côte d’Ivoire). All patients underwent vaginal cure of cystocele. The results of the operation were assessed on the basis of judgment criteria. The parameters studied were: age, marital status, profession, history, reason for consultation and outcome of the operation. Results: During the study period, five patients underwent vaginal cystocele surgery. The mean age was 46.6 years with extremes of 32 and 63 years. Three patients were married. All patients had a history of obstructed labour due to fetal macrosomia. 4 patients had grade II cystocele and one patient had grade III cystocele. All patients underwent anterior colpo-perineorrhaphy. The average operating time was 56 minutes (45 - 65 minutes). There was no morbidity. The average hospital stay was 3.6 days. The average duration of the urinary catheter was 2.2 days. At three months post-op, 4 patients had a good anatomical and functional result with a very good degree of satisfaction, compared with one patient who was moderately satisfied and had an average anatomical and functional result. At six months, all five patients had a good anatomical and functional result with a very good degree of satisfaction. Conclusion: Cure of cystoceles by the vaginal route is a technique that offers several advantages, especially the significant reduction in patient morbidity. Its anatomical and functional results demonstrate its reliability.

关键词： Cystocele Colpo-Perineorrhaphy genital prolapse

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Sacrospinous Fixation in the Gynecology Department of Hôpital du Mali

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Open Journal of Obstetrics and Gynecology 2021年第1期11卷 20-26页

作者： Traoré Alassane Sissoko Abdoulaye Coulibaly Mamadou Bakary Traoré Soumana Oumar Sima Mahamadou Bocoum Amadou Traoré Soumaila Touré Moustapha Tegueté Ibrahima Traoré Youssouf Obstetrics and Gynecology Department at Hopital du Mali Bamako Mali Obstetrics and Gynecology Department at the Teaching Hospital Mère-Enfant Bamako Luxembourg Obstetrics and Gynecology Department at the Referral Health Center Commune V Bamako Mali Obstetrics and Gynecology Department at the Teaching Hospital Point G Bamako Mali Obstetrics and Gynecology Department at the Teaching Hospital Gabriel Touré Bamako Mali Obstetrics and Gynecology Department at the Regional Hospital of Sikasso Sikasso Mali

Sacrospinous fixation (SSF) or Richter’s intervention (RI) aims to treat genital prolapse by securing the posterior vaginal wall to the small sacrospinous ligament. It is performed by low approach and includes a dissection of the pararectal space, visual exposure of the sacrospinous ligament and a needle with strait needle holder with nonabsorbable threads. It is often associated with a more complex corrective procedure, including cystocele cure, vaginal hysterectomy and posterior myorrhaphy. The objective of this study is to report the results of SSF in the gynecology department of Hopital du Mali. A descriptive study was conducted from September 2014 to September 2015 concerning 37 patients operated on for uterine prolapse (UP). All patients with grade III UP were included in our study in whom a unilateral hysterectomy (UH) and sacrospinous fixation (SSF) were performed. All the patients were scheduled. Preoperatively they had benefited from an assessment and a pre-anesthetic consultation. Hospitalization of at least 24 hours prior to the operation was required. Postoperative follow-up was two years with a physical examination at 3 months, 9 months and 15 months, and phone calls between physical consultations. During the study period, we performed 37 RIs. The mean age of the patients was 48 years with extremes of 41 to 73 years. The large multiparity was found out in 35 cases (94.59%), the pauciparous were two with 3 deliveries for each. Long labor of more than 18 hours was found out in 9 patients (24.32%) and home delivery in 13 cases (35.13%). The duration of the occurrence of prolapse was at least two years and 35 patients were going through menopause. The type of anesthesia used for the surgery was spinal anesthesia for all patients. The average duration of the operation was 90 minutes. Complications occurred in three patients or 8.10% of cases, two cases of acute urine retention and one case of hematoma of the para-rectal space. The medium time of hospital stay was 5 days. The anatomical result was satisfa

关键词： Sacrospinous Fixation genital prolapse Hôpital du Mali

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