Morbidity of incontinence surgery in women over 70 years old: a retrospective cohort study.
OBJECTIVE
To compare the success rate and complications after colposuspension and tension-free vaginal tape (TVT) insertion in women aged 70 years or more compared with younger women.


METHODS
A retrospective study of patients having surgery between November 2000 and October 2002.


METHODS
A tertiary referral, academic urogynaecology unit in a University teaching hospital.


METHODS
Two hundred and twenty-six women having surgical treatment for urinary incontinence.


METHODS
Data on cure/improvement and complications were extracted from the notes. Patients were grouped by age at surgery and the odds ratios (OR) and 95% confidence intervals (CI) for each outcome were calculated.


METHODS
Subjective cure rate and the incidence of complications by age group.


RESULTS
One hundred and three patients had colposuspension, 11 (10.7%) aged 70 or more. One hundred and twenty-three patients had TVT insertions, 23 (18.7%) aged 70 or more. The cure rate for each procedure was similar between age groups. After colposuspension, urinary tract infection (UTI; OR 11.33; 95% CI 2.61, 49.28) and long term self-catheterisation (percentage of difference 9.1; 95% CI 3.0, 15.2) were more common in women over 70. After TVT, repeat urodynamics (OR 3.91; 95% CI 1.11, 13.76), recurrent UTI (OR 4.22; 95% CI 1.03, 17.26) and tape division (OR 29.12; 95% CI 3.20, 264.86) were more common in older women.


CONCLUSIONS
Incontinence surgery carries a higher risk of complications in the elderly including UTI and voiding dysfunction. Extended antibiotic prophylaxis and intermittent self-catheterisation training should be offered to elderly women before surgery.
Pugsley
Harriet
H
Urogynaecology Department, Women's Perinatal and Sexual Health Directorate, University Hospitals of Leicester, UK.
Barbrook
Christopher
C
Mayne
Christopher J
CJ
Tincello
Douglas G
DG
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D011098:Polyglactin 910 / Q000627:therapeutic use*; D011183:Postoperative Complications / Q000209:etiology*; D012189:Retrospective Studies; D013536:Suture Techniques; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D014596:Uterine Prolapse / Q000601:surgery; D014621:Vagina / Q000601:surgery*
D011098:Polyglactin 910