One in two women will one day be the victim of organ descent, what doctors call prolapse, a disease that is very common but also somewhat taboo. However, there are different effective treatments; a decision to be made with the patient.
According to Prof. Jean-Nicolas Cornu, from Rouen University Hospital, interviewed during the AFU (Association Française d’Urologie) congress which has just ended in Paris, this does indeed represent a large number of women, potentially, but for a large number of them, without them necessarily realizing it.
On the other hand for 10%, there will be troublesome symptoms which will require a surgical intervention. It will be urologists, gynecologists and gastroenterologists who, all together, make a decision on the type of operation to be offered. When a decision has to be made because the symptoms are there, an assessment is first necessary and it is not a menu with different checkboxes, each case being very different. The additional examinations are chosen according to the symptoms and the profile of the patient. When this assessment is made, a decision can be made.
Two possible operations
Today, prolapse is treated in two ways: either through the stomach with a mini scar, or through the vagina. This vaginal surgery uses two possible techniques: a so-called autologous repair, where the patient’s tissues are used to strengthen the pelvic tissues which are deficient, or the fitting of a reinforcing prosthesis.
These vaginal prostheses are interesting tools, but must be used after consultation and reflection in particular conditions: in patients who have a high risk of recurrence, in those for whom the approach by the belly is not possible, or in failure of other treatments.
Case by case
Today, only surgery can cure prolapse, because drugs cannot, nor physiotherapy, which has modest effects. Finally, we cannot insist enough on the fact that the decision, and in particular the surgical one, must be taken after a discussion with the patient: the explanatory memorandum, the benefit / risk ratio, and all that is the cornerstone of a good decision, with of course, an adapted follow-up over time, because the long-term results are still not well known.
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