[Surgical treatment of severe dyspareunia (personal technic)].

UNLABELLED: Deep dyspareunia is taken to describe pain "in the base of the abdomen" which, without interfering with penetration, accompanies (or follows) sexual intercourse. Amongst uterine malpositions, two forms have been widely described: retroflexion and retroversion. Emphasis should be placed upon another aspect where the uterus, without any break in the angle between cervix and body, falls as a whole onto the anterior surface of the cervix and the posterior perineum. Clinical manifestations are identical in all three forms.

OPERATIVE TECHNIQUE: this is designed not only to restore the physiological angulation of the uterus but to ensure that the vagina is of adequate functional width. It is a compromise between posterior hysteropexy (Huguier), "douglassectomy" and exclusion of the pouch of Douglas (Bret and Bardiaux). This technique has been used in a total of 144 operations in the treatment of 71 cases of malposition and the results compared with other techniques: anterior fixation (4 cases), posterior hysteropexy (38 cases), exclusion of the pouch of Douglas (25 cases) and round ligament plasty (5 cases).