Early voiding difficulty after colposuspension

Objective To determine the incidence of post-operative voiding dysfunction (POVD) after colposuspension and to identify pre-operative risk factors. Patients and methods A retrospective study of 100 women having colposuspension to determine the preoperative clinical assessment (history, physical examination, symptom-specific questionnaire and visual analogue scare assessment of urological symptoms), pre-operative urodynamic investigations (uroflowmetry, twin-channel subtracted cystometry and video-cystourethrography), information on post-operative catheter management and the presence and management of any POVD. Results Twenty-one women experienced significant POVD attributable to their colposuspension. This resolved within 6 months in 19, but persisted beyond 6 months in two. Women experiencing POVD were significantly older and were more likely to have previously undergone a hysterectomy. The risk of POVD was 12% for those aged <50 years, 25% at age 50-64, and 50% for those over 65 years. The duration of post-operative catheterization was related to the presence of symptoms of voiding difficulty. Conclusions The risk of POVD after colposuspension increases with age. In women over 65 years old, consideration should be given to an elective temporary discharge home with a suprapubic catheter in situ for 7-10 days before initiating a catheter-clamping regimen.