Search

Introduction: The use of prosthetic surgery by vaginal route has been widely used to try to reduce the risk of prolapse recurrence in the surgical treatment of vaginal cystoceles. Specific complications including type of erosion have led to randomized studies comparing surgery by vaginal route with and without use of Mesh., Method: This work is based on a systematic review of the literature (PubMed, Medline, Cochrane Library, Cochrane database of systemactic reviews, EMBASE) for meta-analyzes, randomized trials, registries, literature reviews, controlled studies and major not controlled studies, published on the subject. Its implementation has followed the methodology of the HAS on the recommendations for clinical practice, with a scientific argument (with the level of evidence, NP) and a recommendation grade (A, B, C, and professional agreement (AP))., Results: The use of inter-vesicovaginal synthetic mesh improves the anatomical result compared to the autologous surgery for the treatment of cystocele (NP1). However, there is no difference in the functional outcome and there is an increase in the number of reoperations related to specific complications, including vaginal erosions., Conclusion: If the use of inter-vesicovaginal synthetic mesh improves the anatomical result compared to the autologous surgery for the treatment of cystocele (NP1), no difference in functional outcome and the increased number of related reoperations specific complications including vaginal erosions, do not argue for the systematic use of mesh in the treatment of primary cystocele. It must be discussed case by case basis taking into account a risk-benefit uncertain at long-term (grade B). Its use should be supported by additional studies focused on specific populations at risk of recurrence. © 2016 Published by Elsevier Masson SAS., (© 2016 Elsevier Masson SAS. Tous droits réservés.)

Aims: Determine the aetiologic factors and evaluate the result of our chirurgical treatment., Patients and Methods: It was about a prospective study done from October 1st 2005 to March 31,2007 on all women seen for urinary discomfort in whom cystocele have been found., Results: The hospital frequency of cystocele has been 3.54%. The mean age of our patients has been 48 years. In the patient history dystocic delivery have been found in 7 cases (43.75%), foetal macrosomia in 7 cases, chronic constipation in 1 case (6.25%) and 4 patients were menopausal. For the parity 10 patients were big multi pares, 3 were multi pares (18.75%), 2 were pauci pares (12.5%) and 1 were nullius pare. Cystocele were classed 1st degree in 3 patients, 2nd degree in 9 patients (56.25%) and 3rd degree in 4 others (25%). Anterior plasty of the vaginal wall was done in 11 patients (68.75%) and anterior and posterior plasty of the vaginal wall in 5 patients (31.25%). After 6 months, 62.5% of patients have a good anatomic result and 68.75% a good functional result. Anatomic results were bad in 6.25%. Cystocele is frequent in young women in Mali. It is often related to obstetrical trauma. A rapid diagnosis and care will improve the prognosis.