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[Enterocele. Retrospective study of 134 cases: risk factors and comparison between abdominal and perineal routes]
A Delest1, M Cosson, C Doutrelant
1Clinique Universitaire de Gynécologie, Pavillon Paul-Gellé, Roubaix.
Objective:
Our purpose was to assess etiological factors in enterocele and to compare abdominal sacral colpopexy with mesh and resection of the cul-de-sac of Douglas to transvaginal sacrospinous colpopexy.
Methods:
A retrospective study, for 20 years, concerned 134 patients clinically proved enterocele confirmed during the operation.
Results:
Etiological factors were: multiparity, perineal tear, foetal macrosomia, instrumental extractions, antecedents of gynaecologic operations, tissular and constitutional factors. The analysis of the anatomical and functional results did not distinguish between the two surgical procedures, each with its proper indications.
Conclusion:
For patients 60 years old or older, we propose the transvaginal sacrospinous colpopexy. Before 50 years, we prefer abdominal sacral colpopexy with mesh. Between 50 and 60 years, each case must be examined with the health status of the patients.