The Long-Term Outcome of the Turner-Warwick Vaginal Obturator Shelf Urethral Repositioning Colposuspension Procedure for Urodynamically Proven Stress Urinary Incontinence.
OBJECTIVE
To analyze long-term continence, voiding dysfunction and secondary prolapse rates following Turner-Warwick Vaginal Obturator Shelf Urethral Repositioning colposuspension (VOSURP) for urodynamically proven stress urinary incontinence (USUI).


METHODS
Telephone and/or outpatient review of the outcomes of 50 consecutive patients undergoing VOSURP between 1997 and 2008 was conducted. Outcomes assessed included urinary continence (pad free/leak free), need to self-catheterise (ISC), secondary posterior pelvic organ prolapse (POP) development and need for further continence and POP-related surgical interventions. All patients with continued/recurrent urinary incontinence had repeat videourodynamics.


RESULTS
At a median follow-up of 108.5 months (17-153), complete urinary continence was reported in 41 (82%) of patients, post procedure new onset ISC in 2 (4%) and new onset posterior POP in 2 (4%). The cause of continued urinary incontinence was persistent USUI in 3 (6%), new onset idiopathic detrusor overactivity (IDO) in 4 (8%) and failure of resolution of pre-existing IDO in 2 (4%).


CONCLUSIONS
Long-term complete urinary continence and cure of USUI following VOSURP are excellent at 82 and 94%, respectively. Voiding dysfunction and secondary POP procedure rates are low. The VOSURP is an excellent alternative to classical Burch colposuspension for the treatment of primary and recurrent USUI.
University College London Hospital, London, UK.
Tamsin
T
Greenwell
Paras
P
Shah
Rizwan
R
Hamid
P Julian R
PJ
Shah
Jeremy
J
Ockrim
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008875:Middle Aged; D012189:Retrospective Studies; D053825:Suburethral Slings; D013997:Time Factors; D016896:Treatment Outcome; D014521:Urethra; D014550:Urinary Incontinence, Stress / Q000503:physiopathology* / Q000601:surgery*; D014563:Urodynamics; D013520:Urologic Surgical Procedures / Q000379:methods; D014621:Vagina