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Narrated video of a re‐do colposuspension
Author(s) -
Cardozo Linda,
Robinson Dudley,
Shakir Fevzi
Publication year - 2017
Publication title -
neurourology and urodynamics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 90
eISSN - 1520-6777
pISSN - 0733-2467
DOI - 10.1002/nau.23114
Subject(s) - medicine , sling (weapon) , urinary incontinence , stress incontinence , surgery , pelvic floor , hysterectomy
Aims 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. Conclusion 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.