Douleur pelvi-périnéales et prolapsus génital : revue de la littérature
Open accessAbstract
Les douleurs pelvi-périnéales postchirurgie du prolapsus génital sont des complications postopératoires graves et fréquentes dont le diagnostic et le traitement peuvent être complexes. Nous avons réalisé une revue de la littérature sur la base de données Pubmed en utilisant les mots et MeSH suivants : genital prolapse, pain, dyspareunia, genital prolapse and pain, genital prolapse and dyspareunia, genital prolapse and surgery, pain and surgery. Parmi les 133 articles trouvés, 74 ont été retenus. Les douleurs pelvi-périnéales chroniques évoluent depuis plus de 3 mois selon l’International Association for the Study of Pain, et peuvent être de type nociceptif, neuropathique ou dysfonctionnel. Leur définition est avant tout clinique. Leur incidence varie de 1 à 50 % et les facteurs de risques suspectés sont un âge jeune, des comorbidités, un antécédent de chirurgie de prolapsus, un stade élevé de prolapsus, des douleurs préopératoires, une voie d’abord chirurgicale invasive, la pose simultanée de plusieurs prothèses, une moindre expérience de l’opérateur, une durée importante d’intervention et des douleurs postopératoires précoces. La voie vaginale peut favoriser une modification de la compliance ou de la longueur vaginale, des lésions des nerfs pudendaux, sciatiques ou obturateurs ou un syndrome myofascial pelviens ; la voie cœlioscopique est à risque de lésion des nerfs pariétaux ; la chirurgie prothétique implique des complications liées aux modifications de prothèse. La prise en charge thérapeutique est complexe et doit être multimodale et pluridisciplinaire. Les connaissances sur les douleurs pelvi-périnéales après chirurgie du prolapsus génital sont encore limitées à ce jour. Pelvic and perineal pain after genital prolapse surgery is a serious and frequent post-operative complication which diagnosis and therapeutic management can be complex. A literature review was carried out on the Pubmed database using the following words and MeSH : genital prolapse, pain, dyspareunia, genital prolapse and pain, genital prolapse and dyspareunia, genital prolapse and surgery, pain and surgery. Among the 133 articles found, 74 were selected. Post-operative chronic pelvic pain persisting more than 3 months after surgery according to the International Association for the Study of Pain. It can be nociceptive, neuropathic or dysfunctional. Its diagnosis is mainly clinical. Its incidence is estimated between 1% and 50% and the risk factors are young age, the presence of comorbidities, history of prolapse surgery, severe prolapse, preoperative pain, invasive surgical approach, simultaneous placement of several meshes, less operator experience, increased operative time and early post-operative pain. The vaginal approach can cause a change in compliance and vaginal length as well as injury to the pudendal, sciatic and obturator nerves and in some cases lead to myofascial pelvic pain syndrome, whereas the laparoscopic approach can lead to parietal nerve damage. Therapeutic management is multidisciplinary and complex. Pelvic pain after genital prolapse surgery is still obscure to this day.
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“New-onset dyspareunia affects about 7% two years after vaginal repair [13,14,16,17].”
- Authors
- Mortier, A., Cardaillac, C., Perrouin-Verbe, M.-A., Meurette, G., Ploteau, S., Lesveque, A., Riant, T., Dochez, V., & Thubert, T.
- Affiliations
- Centre Hospitalier Universitaire de Nantes (FR)
- Corresponding author
- Thubert, T.
- Venue
- Progrès en Urologie
- Publisher
- Elsevier BV
- Published
- 2020-09
- Volume
- 30
- Issue
- 11
- Pages
- 571-587
- ISSN
- 1166-7087 (ISSN-L)
- OpenAlex
- W3040789847
- Cited by
- 2
- References
- 90
- Citations by year
- 2026: 1 · 2024: 1
- FWCI
- 0.00
- Type
- journal article
- Language
- fr
- Open access
- hybrid
- doi.org
- Licence
- Locations
- The French Journal of Urology (acceptedVersion, other-oa)
- PubMed (publishedVersion)
- HAL (submittedVersion, cc-by-nc)
- Topics
- Health Sciences › Medicine › Rheumatology › Pelvic floor disorders treatments
- Health Sciences › Medicine › Surgery › Hernia repair and management
- Health Sciences › Medicine › Psychiatry and Mental health › Sexual function and dysfunction studies
- Keywords
- pelvic organ prolapse, postoperative complications, dyspareunia, chronic pain, risk factors, vaginal approach, laparoscopic approach, pudendal nerve injury, obturator nerve injury, sciatic nerve injury, pelvic floor dysfunction, neuropathic pain, multimodal pain management
- MeSH terms
- Humans, Perineum, Postoperative Complications, Reoperation, Pelvic Pain, Pelvic Organ Prolapse
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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