Treatment / Colposuspension

Colposuspension: What You Need to Know

Indication:

Colposuspension is a surgical procedure primarily indicated for women who experience stress urinary incontinence. Stress urinary incontinence is the involuntary leakage of urine during activities that increase intra-abdominal pressure such as coughing, sneezing, lifting, or exercising. The procedure involves lifting and suspending the neck of the bladder in order to restore its normal position and improve urinary control.

Alternatives:

Before opting for surgery, it’s important to consider non-surgical alternatives:

1. Pelvic Floor Exercises: Commonly referred to as Kegel exercises, these exercises can strengthen the muscles that control urination.
2. Medications: Some drugs can help tighten or relax muscles that control urine flow.
3. Pessaries: These are devices inserted into the vagina to support the bladder.
4. Lifestyle Changes: Weight management, adjusting fluid intake, or avoiding certain trigger activities can be beneficial.
5. Other Surgical Procedures: Procedures such as tension-free vaginal tape (TVT) or urethral bulking agents may be considered.

Operation Details:

Under general or regional anaesthesia:

1. An incision is made in the lower abdomen.
2. The neck of the bladder is identified and lifted.
3. Stitches are placed to suspend the bladder neck to nearby ligaments.
4. The incision is closed.

What to Expect:

• Duration: The surgery typically lasts 1-2 hours.
• Hospital Stay: Most women stay in the hospital for 1-3 days post-surgery.

Postoperative Course:

1. Activity: Expect some physical limitations for a few weeks. Refrain from heavy lifting or strenuous activities.
2. Pain Management: Some pain or discomfort is normal. Painkillers will be prescribed.
3. Catheter: A urinary catheter may be in place shortly after surgery.
4. Follow-up: Regular follow-up appointments will ensure proper healing and monitor for complications.

Risks:

All surgeries come with risks. For colposuspension, potential risks include:

1. Urinary tract infections
2. Difficulty emptying the bladder
3. Urinary urgency or increased frequency
4. Injury to nearby organs
5. Blood clots or bleeding
6. Anesthesia-related complications

Recovery:

• Full Recovery: Most women fully recover in 4-6 weeks.
• Sexual Activity: It is recommended to wait at least 6 weeks before resuming sexual activity.
• Driving: Discuss with your doctor, but most women can drive after a couple of weeks.

Success Rate:

Colposuspension has a high success rate. Studies have shown that about 85-90% of women experience significant improvement or cure of incontinence symptoms after the procedure. However, it’s worth noting that success rates can vary based on individual factors and the surgeon’s experience.

In Conclusion

Colposuspension is a reliable surgical option for treating stress urinary incontinence. Discuss with your healthcare provider to determine if it’s right for you and to understand all potential risks and benefits.

Further Reading

1. British Association of Urological Surgeons Leaflet on Stress Incontinence Treatment Options
2. British Association of Urological Surgeons Leaflet on Colposuspension
3. NICE  – Patient Decision-Making Tool for Stress Urinary Incontinence