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.