[Abdominal colposuspension--the gold standard in incontinence therapy?]

Abdominal colposuspension has become the operation of choice in moderate and severe urinary incontinence in the female. The operation involves an elevation of the bladder neck and approximation to the back of the symphysis pubis, resulting in an improved pressure transmission to the proximal urethra. These operative techniques have become standardised, while the various modifications differ in the exact location of the sutures in the vaginal fascia and connective tissue in the small pelvis. Most commonly, the sutures are placed lateral of the bladder neck and passed through the ileo-pectineal ligament (Cooper ligament). Even in unfavourable cases, success-rate lies between 70% and 90%.