Slaoui Amine, Slaoui Aziz, Himmi Yassir, Mouftah Babty, Mamad Ayoub, Karmouni Tarik, El Khader Khalid, Baydada Aziz, Koutani Abdellatif, Iben Atyya Ahmed
Urology Department, Avicenne Hospital, University Hospital Center IBN SINA, University Mohammed V, Morocco.
Gynaecology-Obstetrics and Endoscopy Department, Maternity Souissi, University Hospital Center IBN SINA, University Mohammed V, Rabat, Morocco.
Int J Surg Case Rep. 2022 Jun;95:107198. doi: 10.1016/j.ijscr.2022.107198. Epub 2022 May 16.
Pelvic organ prolapse (POP) significantly impairs women's quality of life. The literature reports that nearly one in five women will require surgery in their lifetime, and nearly 40.6% involve anterior wall repair, specifically cystocele. Several techniques and surgical approaches have been used for cystocele management. These were performed by transvaginal and/or transabdominal approach and involved the use of native tissue or prosthesis. Nevertheless, since the transvaginal mesh ban recommended by the FDA and learned societies, autologous tissue repair has become the cornerstone of all vaginal prolapse surgery.
We hereby present the case of a 71-year-old widow who had undergone three vaginal deliveries. The patient reported that she no longer had sexual intercourse. The preoperative functional signs observed included: stress urinary incontinence, urinary urgency, dysuria and disabling vaginal ball feeling. The management strategy chosen in consultation with the patient was a repair using autologous material via the vaginal route. The vaginal strips were passed through trans-obturator and retro pubic route allowed support of the bladder.
This technique using autologous material was easy, fast and inexpensive. It was developed on the basis of the TVT and TOT techniques and stood out for its tolerance and long-lasting functional effectiveness. It avoids all the complications due to polypropylene trans-vaginal prostheses that led to the banning of trans-vaginal mesh.
盆腔器官脱垂（POP）严重影响女性的生活质量。文献报道，近五分之一的女性一生中需要接受手术治疗，其中近40.6%涉及前壁修复，特别是膀胱膨出。膀胱膨出的治疗采用了多种技术和手术方法。这些手术通过经阴道和/或经腹途径进行，涉及使用自体组织或假体。然而，自美国食品药品监督管理局（FDA）和学术团体建议禁止使用经阴道网片以来，自体组织修复已成为所有阴道脱垂手术的基石。
我们在此介绍一位71岁经三次阴道分娩的寡妇的病例。患者报告称她已不再有性生活。术前观察到的功能症状包括：压力性尿失禁、尿急、排尿困难和严重的阴道坠胀感。与患者协商后选择的治疗策略是经阴道途径使用自体材料进行修复。阴道条带通过闭孔和耻骨后途径放置，以支撑膀胱。
这种使用自体材料的技术简便、快速且成本低廉。它是在经阴道无张力尿道中段吊带术（TVT）和经闭孔无张力尿道中段吊带术（TOT）技术的基础上发展而来的，以其耐受性和持久的功能效果而突出。它避免了因聚丙烯经阴道假体导致经阴道网片被禁用的所有并发症。
