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Colposuspension after previous failed incontinence surgery: a prospective observational study
Objective:
To evaluate the outcome of colposuspension for genuine stress incontinence in women who had previously undergone bladder neck surgery.
Design:
Prospective observational study.
Setting:
Tertiary referral urogynaecology unit.
Participants:
Fifty-two consecutive women with recurrent genuine stress incontinence operated on by one surgeon.
Main Outcome Measures:
Subjective and objective cure of stress incontinence. Complications of surgery.
Results:
The mean age of the women was 51 years (range 28-72) and weight 72.7 kg (range 53-112). Sixty-five continence procedures had been performed previously, with 13 women (25%) having had more than one operation. Nine months post-operatively the subjective cure rate was 80% and objective cure rate 78%. Intraoperative complications were few but included two bladder injuries and one rectus muscle tear which required repair. Seven women (13%) developed voiding difficulties which required clean intermittent self-catheterisation, but only one needed to continue this for six months. None of the women developed detrusor instability.
Conclusions:
In this setting colposuspension after previous bladder neck surgery offers a high rate of success. However, long term follow up is needed to see if this effect is maintained.