Prolapse
Conditions
Keywords
promontofixation, prolapse surgery
Brief summary
The treatment of gynecological prolapse (organ removal) can be done by laparoscopy or vaginally. Laparoscopy is used in 1 out of 2 cases, but learning is difficult and operation time is long. One of the technical difficulties is related to the sutures to the threads. Some surgeons therefore use a glue to fix prosthetic reinforcements more easily and quickly, but this sizing technique has only been evaluated very little. Our study proposes to compare the technique of suture with the thread at the gluing of the prostheses in order to validate the merits of this new technique
Detailed description
Laparoscopic promontofixation is a surgical technique considered by some as the reference technique. Its difficulty of learning and the duration of operation are factors limiting its diffusion. The use of cyanoacrylate glue is proposed to simplify the procedure, without there being any comparative studies between the sutures over and the sizing of prosthetic reinforcements. The main objective of the study is to compare the operative time of promontofixation by coelioscopy with suture using threads to promontofixation using glue. Secondary objectives are the comparison between the two groups of complications per and postoperative, objective anatomical results and functional results of the tissue reaction judged by clinical examination (palpation) and ultrasound and direct cost.
Interventions
PROCEDURELaparostopic promontofixation using surgical glue
The technique involves implanting a prosthetic tissue (tape) between the bladder and the vagina, suspending the cervix or the vagina affectionately, associated or not with a posterior strip placed between the rectum and the vagina fixed on the small pelvis muscles. Each strip is held by the surgical glue (cyanoacrylate biocompatible adhesive)
PROCEDURELaparostopic promontofixation using threads
The technique involves implanting a prosthetic tissue (tape) between the bladder and the vagina, suspending the cervix or the vagina affectionately, associated or not with a posterior strip placed between the rectum and the vagina fixed on the small pelvis muscles. Each strip is held by sutures with threads
Sponsors
Clinique Beau Soleil
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
FEMALE
Age
40 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. Age\> 40 years 2. Surgical indication of prolapse cure by promontofixation 3. Valid social insurance 4. French spoken and written 5. Informed consent signed 6. No
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Operative time | one day | The time elapsed between incision and closure |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Collection of intra-operative complications | one day | Collection of all the complications during the surgery (visceral wound, peroperative bleeding, other) |
| Collection of per-operative complications | one day | Collection of the per-operative complications: pain at day 0 and day 1 (using the visual analog scale), urinary retention, postoperative haemorrhage or hematoma, fever\> 38 ° 48 h after surgery, other complication |
| Collection of complications at 6 weeks | 6 weeks | Pain by the Visuel Analog Scale, emergency consultation or generalist, rehospitalization / Reintervention, other complications |
| Objective anatomical results at 12 month | 12 months after surgery | International Continence Society - Pelvic organe Prolapse - Quantification (POP Q scale): stage 0 (no prolapse is demonstrated) to stage 4 (vaginal eversion is essentially complete) |
| Objective anatomical results at 6 weeks | Before surgery | International Continence Society - Pelvic organe Prolapse - Quantification (POP Q scale): stage 0 (no prolapse is demonstrated) to stage 4 (vaginal eversion is essentially complete) |
| Objective anatomical results at 6 months | 6 months after surgery | International Continence Society - Pelvic organe Prolapse - Quantification (POP Q scale): stage 0 (no prolapse is demonstrated) to stage 4 (vaginal eversion is essentially complete) |
| Quality of life: pelvic floor distress | Before the surgery | The Pelvic Floor Distress Inventory-20 questionnary: it is both a symptom inventory and a measure of the degree of bother and distress (quality-of-life) caused by pelvic floor symptoms.The PFDI-20 includes 20 questions and 3 scales. Each of the 3 scales is scored from 0 (least distress) to 100 (greatest distress). The sum of the scores of these 3 scales serves as the overall summary score of the PFDI-20 and ranges from 0 - 300. The 3 scales include questions taken from the following widely used outcome measures: Urinary Distress Inventory - 6 questions, Pelvic Organ Prolapse Distress Inventory - 6 questions, and Colorectal-Anal Distress Inventory - 8 questions |
| Tolerance of the prosthesis | 6 weeks | Classification of the complications related to the insertion of protheses (from the International Urogynecological Association) |
Countries
France
Outcome results
None listed