Anterior repair using Bologna procedure: long-term results on stress urinary continence

The aim of this study was to describe the prognostic factors and long-term results on stress urinary continence of the Bologna procedure for bladder neck suspension in women undergoing vaginal repair for large cystocele. This was a cohort study and questionnaire-based outcomes analysis. Subjects were 218 women operated on between 1982 and 1992. Their mean age was 66 years. The Bologna vaginal wall sling was associated with vaginal hysterectomy in 199 cases and with posterior colporrhaphy in 202 cases. Median follow-up was 69 months. Of the 218 patients, 182 were continent at stress (83%). The risk factors were low urethral pressure (<30 cmH(2)O, RR = 2.42), severity of preoperative stress urinary incontinence (RR = 2.01 for grade I, 4.03 for grade II and 8.10 for grade III), and an exteriorized cystocele (RR = 0.45). We concluded that the Bologna procedure allows bladder neck suspension during vaginal repair of cystocele, with good results on future continence.