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Colposuspension

This operation involves an incision in the lower part of the tummy. Stitches are placed inside the pelvis to help to support the opening of the bladder during exercise or coughing. The operation can also be done laparoscopically (key-hole surgery) in most cases. The success rate of this operation is about the same as for mid-urethral slings (eg TOT) and autologous slings (ie about 80% of people are happy with the improvement in their incontinence). 

Colposuspension may be recommended in the following circumstances:

  1. Patients who want to avoid using a synthetic tape such as TVT or TOT
  2. When TVT or TOT have not been successful, or have caused problems.
  3. When there is severe tissue damage from previous surgery or radiotherapy which would make a vaginal tape more difficult.\
  4. Where there is a significant prolapse of the front wall of the vagina that also needs treatment
  5. Patient preference

After colposuspension, some patients notice a slower urinary flow and about 10% have temporary difficulties emptying their bladder. This resolves over time usually; however, 1% of patients do have long-standing difficulties passing urine. There is a small risk of damage to the bladder caused by the stitches. Like with autologous slings and mid-urethral tapers, about 10% of people develop overactive bladder symptoms and urgency, which might need further treatment.

Because colposuspension pulls the front wall of the vagina upwards, it can correct certain types of prolapse affecting the front wall of the vagina. However, about 10% of patients who have a colposuspension will later develop a prolapse of the back wall of the vagina and this might need further treatment later.

For further information, follow this link to the BAUS patient information leaflet on Colposuspension.