abiss CYRENE Instrucciones De Uso página 12

• Diabetes
• Connective tissue disorder
• Coagulation disorder
• The patient should be informed that the benefi cial effects of this surgical procedure may be lost if she
becomes pregnant at any time in the future.
• The patient should be told to consult her physician immediately in the event of any problem or dys-
function, particularly in the event of dysuria, vaginal discharge, bleeding, pain or fever.
• For one month after the procedure, the patient should be warned that they must avoid physical exer-
tion (lifting heavy loads, sport), and refrain from all sexual activity and taking baths. The patient may
resume activities on the advice of her doctor.
INSTRUCTIONS FOR USE
The CYRENE sling is supplied in a sterile pack and must be stored at an ambient temperature. Check
that the packaging is intact prior to use. Do not use the prosthesis if the packaging is open or damaged.
The CYRENE sling can be implanted under general, regional, or local anesthesia.
The sling should be carefully examined prior to implantation. Do not use the sling if it is damaged in
any way.
We will only describe the transobturator approach. Implantation via a retropubic approach is possible
and can be accomplished using an appropriate tunnelling device. The description below is not the
surgical procedure. It relates to points concerning the use of CYRENE. The surgeon must be trained in
the surgical procedure before implanting the sling.
We will only describe the steps that are specifi c to the CYRENE sling.
Transobturator procedure (Out-In approach)
- After incision of the vaginal mucosa with a cold knife and opening of the fascia with Mayo scissors,
on each side make 2 passages between the fascia and urethra until abutting the perineal membrane
and the posterior edge of the ischiopubic rami. Do not open the perineal membrane.
- Never dissect between the fascia and mucosa as there is an increased risk of vaginal erosion, extru-
sion and necrosis.
- Perform the external cutaneous counter incisions of the labia majora on a horizontal line passing
between the clitoris and the urethral meatus. This punctiform incision is located internally of the ischio-
pubic ramus.
- Passage of the instrumentation following a horizontal OUT/IN path. This passage follows 3 stages:
● fi rstly, after a contact with the bone, passage of the instrumentation externally of the ischiopubic
ramus
● secondly, after the passage externally and behind the bone, sharp orientation of the instrumentation
horizontally until it makes contact with the operator's fi nger situated between the urethra and the fascia
under the ramus. Passage across the obturator muscles.
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