Cystocèle : place des implants de renforcement par voie vaginale

The advantages of vaginal way in the treatment of cystocele are simplicity, rapidity, peritoneal security. Raphy is subject to recidive. The meshes replace the weak fascia in its role of hammock (Delancey) for the bladder. The mesh covers the central and lateral fascial defects. The procedure consists in a short vertical colpotomy, vesicovaginal dissection, uterine preservation (if uterus is not pathologic), no vaginal excision. The mesh can be spread without fixation, fixed or anchored by arms in the obturator foramen. The results show a significative improvement in the risk of redux cystocele. Complications become less frequent with the expertise and quality of new meshes. Implants are a new vaginal evolving surgery: it must be evaluated by experts and practiced by experienced in vaginal approach surgeons.