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[Bologna procedure in stress urinary incontinence with stage III cystocele (with or without vaginal hysterectomy)].
Prog Urol. 1999 Feb; 9(1):81-7.PU

Abstract

OBJECTIVES

The vaginal approach constitutes a solution for all types of urinary stress incontinence (USI). The type of surgery depends on the position of the bladder neck and urethra, the quality of the sphincter and the severity of genital prolapse. The objective of this study was to evaluate the efficacy of the Bologna procedure in the treatment of urinary stress incontinence (USI) with stage III cystocele.

MATERIAL AND METHODS

This procedure can repair genital prolapse and USI via a 2 cm suprapubic incision, with vaginal hysterectomy, and intraoperative cystoscopy. The patient is placed in the lithotomy position and a Crossen T-shaped vaginal incision is made releasing the anterior wall and allowing the creation of 2 pedicled vaginal flaps posterior to the urethral meatus. The flaps, passed through the suprapubic pelvic fascia, support the bladder neck by means of 2 nonresorbable sutures to the rectus abdominis muscles. Fifty-four patients were treated by the Bologna procedure with or without vaginal hysterectomy from 1990 to 1996 and were reviewed with a mean follow-up of 30 months (16 to 46 months). All women (mean age: 63.4 years) underwent a preoperative clinical examination, renal ultrasound, cystoscopy and urodynamic assessment (37 cases).

RESULTS

Twelve patients developed postoperative complications (9 local infections, 3 cases of deep vein thrombosis with one pulmonary embolism). All complications were treated by local drainage and/or removal of the suspension sutures. Continence was excellent in 45 women (83.3%), improved in 4 (7.4%), and unchanged in 5 (9.3%). The anatomical results were excellent with correction of prolapse in 48 patients (89%). Six patients subsequently developed prolapse of the vaginal dome and 5 complained of voiding discomfort.

CONCLUSION

USI and genital prolapse must be treated simultaneously. The vaginal approach is minimally invasive and can treat both diseases during the same operation.

Authors+Show Affiliations

Service d'Urologie, CHU de Rennes, France.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
English Abstract
Journal Article

Language

fre

PubMed ID

10212956

Citation

el Khader, K, et al. "[Bologna Procedure in Stress Urinary Incontinence With Stage III Cystocele (with or Without Vaginal Hysterectomy)]." Progres En Urologie : Journal De l'Association Francaise D'urologie Et De La Societe Francaise D'urologie, vol. 9, no. 1, 1999, pp. 81-7.
el Khader K, Guillé F, Mhidia A, et al. [Bologna procedure in stress urinary incontinence with stage III cystocele (with or without vaginal hysterectomy)]. Prog Urol. 1999;9(1):81-7.
el Khader, K., Guillé, F., Mhidia, A., Ziadé, J., Patard, J. J., & Lobel, B. (1999). [Bologna procedure in stress urinary incontinence with stage III cystocele (with or without vaginal hysterectomy)]. Progres En Urologie : Journal De l'Association Francaise D'urologie Et De La Societe Francaise D'urologie, 9(1), 81-7.
el Khader K, et al. [Bologna Procedure in Stress Urinary Incontinence With Stage III Cystocele (with or Without Vaginal Hysterectomy)]. Prog Urol. 1999;9(1):81-7. PubMed PMID: 10212956.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Bologna procedure in stress urinary incontinence with stage III cystocele (with or without vaginal hysterectomy)]. AU - el Khader,K, AU - Guillé,F, AU - Mhidia,A, AU - Ziadé,J, AU - Patard,J J, AU - Lobel,B, PY - 1999/4/23/pubmed PY - 1999/4/23/medline PY - 1999/4/23/entrez SP - 81 EP - 7 JF - Progres en urologie : journal de l'Association francaise d'urologie et de la Societe francaise d'urologie JO - Prog Urol VL - 9 IS - 1 N2 - OBJECTIVES: The vaginal approach constitutes a solution for all types of urinary stress incontinence (USI). The type of surgery depends on the position of the bladder neck and urethra, the quality of the sphincter and the severity of genital prolapse. The objective of this study was to evaluate the efficacy of the Bologna procedure in the treatment of urinary stress incontinence (USI) with stage III cystocele. MATERIAL AND METHODS: This procedure can repair genital prolapse and USI via a 2 cm suprapubic incision, with vaginal hysterectomy, and intraoperative cystoscopy. The patient is placed in the lithotomy position and a Crossen T-shaped vaginal incision is made releasing the anterior wall and allowing the creation of 2 pedicled vaginal flaps posterior to the urethral meatus. The flaps, passed through the suprapubic pelvic fascia, support the bladder neck by means of 2 nonresorbable sutures to the rectus abdominis muscles. Fifty-four patients were treated by the Bologna procedure with or without vaginal hysterectomy from 1990 to 1996 and were reviewed with a mean follow-up of 30 months (16 to 46 months). All women (mean age: 63.4 years) underwent a preoperative clinical examination, renal ultrasound, cystoscopy and urodynamic assessment (37 cases). RESULTS: Twelve patients developed postoperative complications (9 local infections, 3 cases of deep vein thrombosis with one pulmonary embolism). All complications were treated by local drainage and/or removal of the suspension sutures. Continence was excellent in 45 women (83.3%), improved in 4 (7.4%), and unchanged in 5 (9.3%). The anatomical results were excellent with correction of prolapse in 48 patients (89%). Six patients subsequently developed prolapse of the vaginal dome and 5 complained of voiding discomfort. CONCLUSION: USI and genital prolapse must be treated simultaneously. The vaginal approach is minimally invasive and can treat both diseases during the same operation. SN - 1166-7087 UR - https://www.unboundmedicine.com/medline/citation/10212956/[Bologna_procedure_in_stress_urinary_incontinence_with_stage_III_cystocele__with_or_without_vaginal_hysterectomy_]_ L2 - http://www.diseaseinfosearch.org/result/3797 DB - PRIME DP - Unbound Medicine ER -