Abstract
ABSTRACT
The authors report on the surgical technique and the results of the modified Bologna procedure, according to Jacquetin, in the cure of urinary stress incontinence with low maximum urethral closure pressure and large cystocele. The combined vaginal and abdominal approach is replaced by an exclusively vaginal operation, the vaginal bands being sutured to the abdominal wall with a stapler. The aim is to avoid the 16%–20% of abdominal hematomas and abscesses described in the literature. The first 33 patients undergoing this procedure between 1992 and 1994 in the department of Gynecology and Obstetrics at the University Hospital of Caen, France, are evaluated in terms of clinical and urodynamic results. These results are compared with results in the literature. Maximum urethral closure pressure is significantly raised, as in any suburethral sling procedure. Three patients experienced postoperative bladder distention for 4–15 days. The cure rate after follow-up for 2–4 years is 85%. There were one immediate failure and two recurrences after 1 year and two recurrences after 2 years, but two of the four recurrences of incontinence were partial. The subjective satisfaction index was 1 (excellent) in 25 patients (75.8%), 2 (improved but not perfect) in 5 patients (15.1%), and 3 (bad) in 3 patients (9.1%). The major complication was secondary enterocele (3 patients). The modified Bologna procedure avoids parietal complications and has a cure rate similar to the cure rate for the traditional procedure. (J GYNECOL SURG 14:1, 1998).
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