PROLAPSUS GENITAUX : ASPECTS EPIDEMIOLOGIQUES DIAGNOSTIQUES ET THERAPEUTIQUES A PROPOS DE 58 CAS.

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Genital prolapse is a permanent or stressful exit through the vagina of one or more components of the pelvic viscera. It is frequent in elder, multiparous and menopausal women. Its diagnosis is clinical and the treatment essentially surgical. The recurrent rate is significant. The aim of our study was to describe the epidemiological, diagnostic, therapeutic and prognostic aspects of genital prolapse in the general surgery department of Aristide Le Dantec Teaching Hospital in Dakar. Materials and method. It was a retrospective study interesting genital prolapse operated in the period of 10 years 6 months from January 1, 2008 to July 31, 2019. The studied parameters were epidemiological data, clinical data, classification, paraclinical data, surgical treatment and results. Results. We collected 58 cases of genital prolapse represented 0.55% of the surgical activity during the study period. The mean age was 59 years with extremes of 25 and 89 years. The most represented age group was 61 and 75 years of age with 25 cases (43.1%). Patients over the age of 60 represented 50.1%. We had 46 cases of multiparous (79.3%) and 11 cases of pauciparous (19%). Postmenopausal patients represented 44 cases (75.8%). The majority of our patients, 67.2%, were housewives with the notion of carrying a heavy charge. All of our patients delivered vaginally with 13.3% obstructed labor. Eight patients (13.7%) had a history of pelvic surgery. The mean duration of symptom was 8 months with extremes of 10 days and 40 years. The functional signs were dominated by the sensation of a vaginal mass in 53 cases (91.3%). We had 13 cases of urinary incontinence (22.4%) and all associated with a cystocel. The three-stage genital prolapse was the most frequent (43.1%). The grade III was the most frequent (43.3%). Pelvic ultrasound was performed in 74.1%. The vaginal route was performed in 56 cases (96%). The triple perineal intervention with hysterectomy was the most performed procedure in 23 cases or 41%. Two cases (4%) of uterine promontofixation by laparotomy was done. The mean of hospital stay was 4 days. Morbidity was 4 cases (6.8%) and was dominated by urinary tract infection. Six cases of recurrence were noted (0.3%). Conclusion:Although the clinical diagnosis is easy, management is uncodified and would require the establishment of a well questionnary. Keywords: genital prolapse, urinary incontinence, vaginal surgery