Colposuspension after previous failed incontinence surgery: a prospective observational study

Abstract

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.