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Factors affecting outcome of colposuspension

A prospective follow-up study of 196 women who underwent a colposuspension operation for genuine stress incontinence (GSI) at the Leicester General Hospital between June 1991 and May 1996 (inclusive) was carried out to review the outcome of surgery. The outcome was based on clinical symptomatology, demonstration of stress incontinence in the clinic and limited postoperative urodynamic studies. The clinical cure rate was 91·33%. Continence rate was reduced by age above 70 years and post-operative urinary tract infections, and not affected by previous colposuspension, or anterior colporrhaphy. On the other hand, previous colposuspension, previous pelvic floor operations and urinary tract infections caused a significantly higher incidence of voiding problems. Older women and those who have had previous bladder neck surgery need special attention in assessment, counselling and in choice of surgery. Reducing postoperative urinary tract infections might help improve the overall outcome of the operation.