Secondary colposuspension: results of a prospective study from a tertiary referral centre

Objective To evaluate the results of secondary colposuspension in women with recurrent urinary stress incontinence. Design Prospective cross sectional observational study. Setting Tertiary referral urogynaecology unit. Population Fifty‐six women with recurrent stress incontinence. Main outcome measures Determine prognostic factors that may affect the outcome of surgery, long term subjective and objective success rates and identify complications of secondary colposuspension. Results The mean age was 54 years (range 34–83) and the median parity was 3 (range 1–5). The median length of follow up was four years (range 1.01–7.07). Forty‐two (75%) women had genuine stress incontinence and 14 (25%) had mixed incontinence on subtracted cystometry. The subjective cure rate was 71% and the objective cure rate was 80% and, as per Kaplan–Meier life time analysis, 65% had not failed surgery five years after the operation. The complication rate was low. However at follow up, eight women had required a posterior colporrhaphy for rectocele and three had a sacrocolpopexy for vault prolapse. Another eight women required further treatment for stress incontinence (seven urethral bulking agents and one tension‐free vaginal tape). There was no correlation of the outcome to age, past hysterectomy, number of previous incontinence procedures, parity, body mass index or blood loss at operation. Conclusion Colposuspension after failed continence surgery has a good outcome with a low complication rate, but many still require further surgery for prolapse.