Management of female pelvic organ prolapse-Summary of the 2021 HAS guidelines.

{"article_title":"Management of female pelvic organ prolapse-Summary of the 2021 HAS guidelines.","author":"Pizzoferrato AC, Thuillier C, V\u00e9nara A, Bornsztein N, Bouquet S, Cayrac M, Cornillet-Bernard M, Cotelle O, Cour F, Cretinon S, De Reilhac P, Loriau J, Pellet F, Perrouin-Verbe MA, Pourcelot AG, Revel-Delhom C, Steenstrup B, Vogel T, Le Normand L, Fritel X","journal_title":"Journal of gynecology obstetrics and human reproduction","issn":"2468-7847","isbn":"","publication_date":"2023-03-01","volume":"52","issue":"3","first_page":"102535","page_count":"","accession_number":"36657614","doi":"10.1016\/j.jogoh.2023.102535","publisher":"Elsevier Masson SAS","doctype":"Practice Guideline","subjects":"Pelvic Organ Prolapse surgery; Genital Diseases, Female; Female; Humans; Aged; Rectocele; Vagina surgery; Gynecologic Surgical Procedures; Pelvic Floor pathology","interest_area":["Obstetrics & Gynecology"],"abstract":"When a patient presents with symptoms suggestive of pelvic organ prolapse (POP), clinical evaluation should include an assessment of symptoms, their impact on daily life and rule out other pelvic pathologies. The prolapse should be described compartment by compartment, indicating the extent of the externalization for each. The diagnosis of POP is clinical. Additional exams may be requested to explore the symptoms associated or not explained by the observed prolapse. Pelvic floor muscle training and pessaries are non-surgical conservative treatment options recommended as first-line therapy for pelvic organ prolapse. They can be offered in combination and be associated with the management of modifiable risk factors for prolapse. If the conservative therapeutic options do not meet the patient's expectations, surgery should be proposed if the symptoms are disabling, related to pelvic organ prolapse, detected on clinical examination and significant (stage 2 or more of the POP-Q classification). Surgical routes for POP repair can be abdominal with mesh placement, or vaginal with autologous tissue. Laparoscopic sacrocolpopexy is recommended for cases of apical and anterior prolapse. Autologous vaginal surgery (including colpocleisis) is a recommended option for elderly and fragile patients. For cases of isolated rectocele, the posterior vaginal route with autologous tissue should be preferentially performed over the transanal route. The decision to place a mesh must be made in consultation with a multidisciplinary team. After the surgery, the patient should be reassessed by the surgeon, even in the absence of symptoms or complications, and in the long term by a primary care or specialist doctor. Competing Interests: Declarations of Competing Interest None. Copyright \u00a9 2023 Elsevier Masson SAS. All rights reserved.","url":"https:\/\/search.ebscohost.com\/login.aspx?direct=true&db=mdl&AN=36657614","isPdfLink":false,"isSAML":false,"an":"36657614","number_other":"","type_pub":"","issn_electronic":"2468-7847","languages":"English","language":"eng","date_entry":"Date Created: 20230119 Date Completed: 20230227 Latest Revision: 20231129","date_update":"20240104","titleSource":"Journal of gynecology obstetrics and human reproduction [J Gynecol Obstet Hum Reprod] 2023 Mar; Vol. 52 (3), pp. 102535. Date of Electronic Publication: 2023 Jan 16.","date_pub_cy":"","type_document":"","contract_publisher":"","authored_on":"2023-03-01","description":"When a patient presents with symptoms suggestive of pelvic organ prolapse (POP), clinical evaluation should include an assessment of symptoms, their impact on daily life and rule out other pelvic pathologies. The prolapse should be described compartment by compartment, indicating the extent of the externalization for each. The diagnosis of POP is clinical. Additional exams may be requested to explore the symptoms associated or not explained by the observed prolapse. Pelvic floor muscle training and pessaries are non-surgical conservative treatment options recommended as first-line therapy for pelvic organ prolapse. They can be offered in combination and be associated with the management of modifiable risk factors for prolapse. If the conservative therapeutic options do not meet the patient's expectations, surgery should be proposed if the symptoms are disabling, related to pelvic organ prolapse, detected on clinical examination and significant (stage 2 or more of the POP-Q classification). Surgical routes for POP repair can be abdominal with mesh placement, or vaginal with autologous tissue. Laparoscopic sacrocolpopexy is recommended for cases of apical and anterior prolapse. Autologous vaginal surgery (including colpocleisis) is a recommended option for elderly and fragile patients. For cases of isolated rectocele, the posterior vaginal route with autologous tissue should be preferentially performed over the transanal route. The decision to place a mesh must be made in consultation with a multidisciplinary team. After the surgery, the patient should be reassessed by the surgeon, even in the absence of symptoms or complications, and in the long term by a primary care or specialist doctor.<br \/>Competing Interests: Declarations of Competing Interest None.<br \/> (Copyright © 2023 Elsevier Masson SAS. All rights reserved.)","upload_link":"https:\/\/search.ebscohost.com\/login.aspx?direct=true&site=eds-live&scope=site&db=mdl&AN=36657614&authtype=shib&custid=ns346513&group=main&profile=eds","no_of_pages":"","authored_by":"Pizzoferrato AC, Thuillier C, V\u00e9nara A, Bornsztein N, Bouquet S, Cayrac M, Cornillet-Bernard M, Cotelle O, Cour F, Cretinon S, De Reilhac P, Loriau J, Pellet F, Perrouin-Verbe MA, Pourcelot AG, Revel-Delhom C, Steenstrup B, Vogel T, Le Normand L, Fritel X"}