What is a Colposuspension to treat Stress Urinary Incontinence?
Colposuspension is an operation to treat stress urinary incontinence in women where the bladder neck (junction of the urethra and the bladder) is elevated and repositioned using abdominal sutures usually placed by a cut in the lower abdomen. The operation can also be performed using keyhole (laparoscopic) surgery.
Colposuspension surgery has been used for over 40 years to treat problems with stress urinary incontinence.
What does the procedure involve?
The procedure involves supporting the neck of the bladder by lifting up the surrounding vaginal tissue with sutures. This is performed under a general anaesthetic by an incision in the lower abdomen or by keyhole surgery. The procedure is combined with a cystoscopy to confirm correct suture placement.
Women are usually admitted to hospital for around 5 days due to the abdominal wound and dissection. The hospital admission is shorter if the procedure is performed using keyhole (laparoscopic) surgery. A catheter (urinary drainage tube) and vaginal pack (wound dressing) is left for up to a couple of days after surgery.
If the patient passes urine well after removal of the catheter (urinary drainage tube) and vaginal pack after the procedure, they can go home.
Restriction in activity is required for at least 4 to 6 weeks after surgery to allow the bladder neck to scar into position and maximise the success of surgery.
How successful is Colposuspension in treating Stress Urinary Incontinence in Women?
Colposuspension has a success rate of about 85% in curing or significantly improving problems with stress urinary incontinence.
What are the potential side effects of Colposuspension surgery for Stress Urinary Incontinence?
All surgery for stress urinary incontinence has potential side effects.
Specific risks associated with colposuspension surgery include:
- Failure to improve or rarely worsening of stress urinary incontinence
- Development of new overactive bladder (OAB) symptoms or worsening of pre-existing OAB symptoms
- Damage to nearby structures such as the bladder, urethra, ureters (tubes draining urine from the kidneys to the bladder), blood vessels and bowel
- Difficulty in urination which may result in the need for intermittent self catheterisation to drain the bladder
- Urinary tract infection
- Wound infection
- Discomfort related to the suspension sutures
- Development of vaginal prolapse (a bulge into the vagina) of the rectum known as a rectocele
- Discomfort related to sexual intercourse
Are there other alternatives to treat Stress Urinary Incontinence in Women?
Many treatment options exist for women with stress urinary incontinence, including:
- Pelvic floor physiotherapy
- Weight loss if overweight
- Continence devices used vaginally
- Sling surgery with synthetic mid-urethral slings
- Sling surgery with fascial or natural tissue slings
- Injectable agents
