title: Narrated video of a re-do colposuspension.
abstract: OBJECTIVE
  To present a narrated video designed to demonstrate the steps involved in an open re-do colposuspension.
  
  
  METHODS
  This was in a 70-year-old woman who presented with recurrent severe stress urinary incontinence. Urodynamics confirmed severe urodynamic stress incontinence, with no detrusor over activity. Her maximum urethral closure pressure (MUCP) was 8 cm/water. She previously had a total abdominal hysterectomy (TAH), bilateral salpingo-oophorectomy (BSO) and colposuspension in 1998. Subsequently, she had a TVT in 2002 and then partial excision of the tape in 2003 due to erosion. This was followed by a Zuidex bulking agent in 2005 and subsequent TOT in 2006. After counselling she opted for a re-do colposuspension.
  
  
  RESULTS
  If primary urinary incontinence surgery has failed the decision as to what treatment should then be undertaken is controversial. The options that are available include a repeat mid urethral sling (either retropubic or transobturator), urethral bulking agents, autologous fascial slings and re-do colposuspension.
  
  
  CONCLUSIONS
  A re-do colposuspension is a sensible choice that is likely to achieve a better success rate than a second tape procedure. Although, colposuspension is an operation that most gynaecologists have now become deskilled in and rarely perform, mainly due to the popularity of tapes. This video demonstrates a re-do colposuspension, with particular attention to the specific nuances that can results in a successful operation.
authors: Department of Urogynaecology, King's College Hospital, Denmark Hill, London, UK.
authors: Linda
authors: L
authors: Cardozo
authors: Department of Urogynaecology, King's College Hospital, Denmark Hill, London, UK.
authors: Dudley
authors: D
authors: Robinson
authors: Department of Urogynaecology, King's College Hospital, Denmark Hill, London, UK.
authors: Fevzi
authors: F
authors: Shakir
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D012086:Reoperation; D053825:Suburethral Slings; D014521:Urethra / Q000601:surgery*; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D014563:Urodynamics; D013520:Urologic Surgical Procedures / Q000379:methods*