Description of a new technique for urethral support which complies with the usual criteria for the efficacy of a surgical cure for stress incontinence without having any of its disadvantages. Presentation of the results, postoperative complications and of the potential role of endovaginal echography in preoperative assessment and follow up. The method can be characterized by: its safety, thanks to the vaginal approach across an operative field the size of a postage stamp, ensuring an uncomplicated postoperative period and a short stay in hospital; its accuracy in suburethral support provided by a strip of expanded polytetrafluoroethylene (Gore-tex soft tissue patch), 30 mm by 10 mm, fixed at the ends to the public insertion of the pubococcygeal tract of the levator muscles, and by its median part to the vesicourethral junction: it is of unrivalled precision, thanks to the peroperative use of an urethrometer which is introduced into the urethra to a certain determined length, either by the application of the formula: urethral length = functional length + 8 mm or, better, from a knowledge of the anatomical length measured between the meatus and the origin of the sphincteral zone during prior endovaginal echography; its efficacy, since the results are stable over time and are obtained without dysuria. These characteristics should make it a first line treatment in the therapeutic arsenal for stress incontinence.

Adult↗

PubMed1988

[Surgical treatment of female stress urinary incontinence. Determination of the location of the vesico-urethral junction].

The accuracy of the various methods used to locate the vesico-urethral junction was evaluated in 20 female patients. In each patient the following parameters were successively measured: functional length of the urethra (urethral profile); distance from the meatus to the posterior lip of the vesical cervix (endoscopy), length of the catheter segment between the balloon and the meatus. Finally, the location of the balloon was determined intra-operatively and compared with the "urethroscopic" findings. The results obtained showed that locating the vesico-urethral junction solely from the location of the balloon could be misleading and that there was a significant difference (nearly 8 mm) between functional and urethroscopic measurements. These results led to a mathematical formula which enables the anatomical length of the urethra to be measured from its functional length. The authors suggest that this length, measured with an urethrometer, should be used for precise location of the junction during surgery for female stress incontinence.

Adult↗

PubMed1987

[Fixation of Gore-Tex slings to the pubococcygeal tendons: a simple technic of treating stress urinary incontinence using only the vaginal approach].

A new technique for curing urinary stress incontinence using the vaginal route and a sling of synthetic material, GORE-TEX, is described. The sling is fixed at one end on the junction between the cervix and the urethra in the centre, and at the edges to the tendons of the pubo-coccygeal muscles. The situation is worked out from a urethral profile. Thirty cases have been treated and the results have been satisfactory. If they are confirmed by other operators it will show that a new reliable technique which is very simple and non-aggressive can be used.

Adult↗

PubMed1986

[Suprapubic transrectal incision for carrying out obstetrical and gynecological surgery. Analysis of 1,545 published cases].

Twelve years experience with 6,000 incisions carried out in the Tertre Rouge clinic in Le Mans and 1,545 cases published by other authors demonstrate that the suprapubic transverse incision with section of the recti abdominis muscle is becoming more popular for pelvic surgery. The technique of the operation and its variations according to different authorities in different countries are fully described. There is also a review of the indications for the procedure, to show how it can be used for caesarean section especially when carried out under epidural anaesthesia. Finally, the incision is compared with those more usually used.

Abdominal Muscles↗

PubMed1981

[Transverse trans-rectus abdominis incision in gynaecological and obstetrical surgery. 673 cases (author's transl)].

A transverse abdominal incision derived from Maylard's incision was used in 673 operations on the lower abdomen. The incision is transverse throughout, including the rectus abdominis muscle. It runs at the upper limit of pubic hair and is lower than Maylard's. The muscles are sectioned above the openings of the inguinal canals. Closure is effected by suturing muscles and aponeuroses. The 673 opérations included 482 gynaecological procedures and 191 cesarean sections. Five hundred and twenty-six patients were examined after 1 to 4 years. Twenty-nine patients were re-operated upon using the same incision, and the firmness of the abdominal wall was confirmed on inspection. Two patients (0.38%) developed hernia; these were elderly women who had undergone gynaecological surgery.

Abdominal Muscles↗

PubMed1971

[Action of lanthanum and the mechanism of milk curdling].

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Animals↗

PubMedDate not supplied

[Treatment of invasive cancer of the vulva. 49 cases].

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Aged↗