title: 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.
  
  
  METHODS
  Prospective observational study.
  
  
  METHODS
  Tertiary referral urogynaecology unit.
  
  
  METHODS
  Fifty-two consecutive women with recurrent genuine stress incontinence operated on by one surgeon.
  
  
  METHODS
  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.
authors.affiliation: Department of Urogynaecology, King's College Hospital, London, UK.
authors.forename: L
authors.initials: L
authors.lastname: Cardozo
authors.forename: A
authors.initials: A
authors.lastname: Hextall
authors.forename: J
authors.initials: J
authors.lastname: Bailey
authors.forename: K
authors.initials: K
authors.lastname: Boos
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008875:Middle Aged; D018579:Patient Selection; D011446:Prospective Studies; D012008:Recurrence; D012086:Reoperation / Q000009:adverse effects / Q000379:methods; D017211:Treatment Failure; D001743:Urinary Bladder / Q000601:surgery*; D014550:Urinary Incontinence, Stress / Q000503:physiopathology / Q000601:surgery*; D014563:Urodynamics; D013520:Urologic Surgical Procedures / Q000009:adverse effects / Q000379:methods