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Predictive Factors for Poor Outcome after Laparoscopic and Open Colposuspension: A Comparative Analysis Using the

Albert Chao Chiet Tan1, Pallavi Latthe2

  • 1Department of Urogynaecology, Birmingham Women's and Children NHS Foundation Trust, Birmingham, UK. alberttancc28@gmail.com.

International Urogynecology Journal
|January 8, 2025
PubMed
Summary
This summary is machine-generated.

Predictors of failed colposuspension surgery differ between laparoscopic and open approaches. Previous pelvic organ prolapse surgery or midurethral sling predicted failure in open colposuspension, while advanced cystocele predicted failure in laparoscopic colposuspension.

Keywords:
Laparoscopic colposuspensionOpen colposuspensionPGIIRisk factors

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Area of Science:

  • Urogynecology
  • Surgical Innovation
  • Pelvic Floor Disorders

Background:

  • Colposuspension has been a standard surgical treatment for stress urinary incontinence (SUI) since 1961.
  • Limited research exists on predictors of poor outcomes for both laparoscopic colposuspension (LC) and open colposuspension (OC).

Purpose of the Study:

  • To identify patient-reported predictors of failure following colposuspension surgery.
  • To compare outcomes and failure predictors between LC and OC procedures.

Main Methods:

  • Retrospective cohort study of women undergoing their first colposuspension surgery.
  • Data collected prospectively on the British Society of Urogynaecology database.
  • Primary outcome: Patient Global Impression of Improvement (PGII) for incontinence; failure defined as PGII score 3-7.

Main Results:

  • Analysis of 3104 women (1181 LC, 1923 OC).
  • In LC, cystocele stage ≥2 predicted failure (OR 2.573, p=0.032).
  • In OC, previous midurethral sling (MUS) (OR 1.807, p=0.008) and previous prolapse surgery (OR 1.954, p=0.004) predicted failure.
  • OC showed higher success rates (p<0.001) with lower adverse events (p<0.001) compared to LC.

Conclusions:

  • Predictors of failed colposuspension vary significantly between LC and OC.
  • Previous pelvic organ prolapse surgery and/or midurethral sling are key predictors for OC failure.
  • Stage ≥2 cystocele is a significant predictor for LC failure.