Trattamento di cistocele con o senza IUS mediante chirurgia mininvasiva con “Vesica kit” modificato

Abstract

Urinary stress incontinence is often related to cystocele, hence treatment cannot exclude correction of the latter. The authors have treated 2nd-3rd grade cystocele secondary to central impairment using a mininvasive technique consisting of a vaginal flap suspended anteriorly to the pubic tubercles, according to the traditional “Vesica kit” procedure, and posteriorly to the iliopubic branches in line with the Cooper ligaments using “Vesica kit” screws inserted through the abdominal wall under videolaparoscopy after creating a pneumo-Retzius space. Whenever a pneumo-Retzius cannot be created due to previous pelvic surgery, the same operation may be performed either through a small sovrapubic incision or by inserting 4 screws in line with the pubis. After 1 year the 20 operated patients show satisfying results with good prospects, but a longer follow-up is necessary to confirm these results. The aim of this study is to describe a mininvasive surgical technique for treating 2nd-3rd grade cystocele, associated or not with urinary stress incontinence.