National survey of surgical practices: Sacropexy in France in 2019
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ORIGINAL ARTICLE
National survey of surgical practices: Sacropexy in France in 2019 Christie Rebahi 1 & Claire Cardaillac 2 & Michel Cosson 3 & Hervé Fernandez 4 & Jean-Francois Hermieu 5 & Jean-Philippe Estrade 6 & Norbert Winer 2 & Vincent Dochez 2 & Thibault Thubert 2 Received: 19 June 2020 / Accepted: 31 August 2020 # The International Urogynecological Association 2020
Abstract Introduction and hypothesis Sacropexy is a reference surgical treatment for pelvic organ prolapse in women. The great variability in surgical techniques for this procedure is a source of bias that complicates analysis of the results of trials assessing it. Using the French guidelines issued in 2016 by the SCGP, AFU, SIFUD-PP, and CNGOF as a reference, we sought to inventory the surgical practices of the surgeons who perform these procedures. Methods In November 2018, a questionnaire about the technical aspects of this procedure was distributed by email to the French physicians performing it. It was distributed to members of several professional societies (CNGOF, SCGP, and SIFUD) and to gynecologists practicing in clinics owned by the ELSAN group. Results Of the 273 responders, 92% reported that they perform most operations laparoscopically. Overall, 83% of gynecologic surgeons used polypropylene prostheses (mesh); 38% routinely placed a posterior mesh, while the rest did so only in cases of clinical rectocele with anorectal symptoms. A concomitant hysterectomy was performed by 51% of respondents when the uterus was bulky and/or associated with substantial uterine prolapse. Finally, half the surgeons suggested the placement of a suburethral sling for women with stress urinary incontinence. Conclusions Although practices are largely consistent with the most recent guidelines, surgical techniques vary widely between surgeons, both in France and internationally. Keywords Laparoscopic . Minimally invasive . Pelvic organ prolapse . Sacrocolpopexy . Sacrocolpohysteropexy . Sacrohysteropexy Congres presentation This work was presented as an oral communication at the SIFUD-PP conference in La Rochelle, France (June 2019), and at the SCGP conference in Lille, France (September 2019) * Thibault Thubert [email protected] 1
Service de gynécologie et d’obstétrique, Centre Hospitalier Universitaire de Brest, Brest, France
2
Service de gynécologie obstétrique, Centre Hospitalier Universitaire de Nantes, Hotel Dieu, 38, boulevard Jean-Monnet, 44093 Nantes, France
3
Service de chirurgie gynécologique de Lille, Hopital Jeanne De Flandre, Lille, France
4
Département de gynécologie et d’obstétrique, AP-HP, GHU-Sud, Hôpital Bicêtre, Le Kremlin Bicêtre, France
5
Service d’urologie, Hôpital Bichat Claude Bernard, Assistance Publique Hôpitaux de Paris, Université Paris-Diderot, 46, rue Henri Huchard, 75018 Paris, France
6
Service de gynécologie obstétrique, Gyneco Marseille Saint-Giniez, Marseille, France
Abbreviations AFU Association Française des Urologues AUGS American UroGynecology Society CEROG Committee for Ethics in Research in O
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