Objectives: The authors conducted a long-term evaluation of a modification of the Peyrera-Raz procedure by creation of a fixed point in the suprapubic fibrous tissue.
Material and methods: The authors report a series of 38 patients who, despite pelvi-perineal rehabilitation, presented urinary stress incontinence corrected by Bonney's manoeuvre. Treatment consisted of Peyrera-Raz percutaneous colposuspension modified by superior anchoring of the sutures to the suprapubic fibrous plane. Preoperative assessment consisted of clinical and urodynamic examination. Postoperatively, patients were regularly reviewed in the outpatients department and long-term evaluation of the results was performed by means of a telephone questionnaire.
Results: The technical modification did not introduce any particular practical difficulty or any specific infectious or painful morbidity. Postoperative self-catheterizations, for an average of 14 days, were required in 6 patients. 9/38 (24%) presented recurrence of their incontinence within the first 6 months; reoperation by a suburethral sling allowed definitive correction of the disorders. 29/38 (76%) were satisfied or very satisfied with the result of their operation with a mean follow-up of 3.2 years, although 6 of them presented minimal incontinence on very intense, unusual efforts.
Conclusion: Percutaneous colposuspension, modified by superior anchoring of the sutures to the suprapubic fibrous tissue, allows effective treatment of urinary stress incontinence with limited morbidity in 3/4 of cases, with a mean follow-up of more than 3 years.