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Do bladder neck position and amount of elevation influence the outcome of colposuspension?
Author(s) -
Bombieri L.,
Freeman R.M.
Publication year - 2003
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1046/j.1471-0528.2003.02391.x
Subject(s) - medicine , neck of urinary bladder , magnetic resonance imaging , stress incontinence , surgery , urology , urinary incontinence , urinary bladder , radiology
Objective To determine whether the amount of bladder neck elevation and the position of the bladder neck after surgery influence the cure rate after colposuspension. Design Prospective, observational study. Setting Urogynaecology unit, district general hospital. Population Seventy‐seven women undergoing colposuspension for urodynamic stress incontinence. Methods The bladder neck was imaged pre‐operatively and one week after surgery using magnetic resonance imaging. The position of the bladder neck after surgery and the amount of elevation were correlated to continence outcome one year after surgery (subjective and objective evidence of stress incontinence). Main outcome measures Subjective and urodynamic stress incontinence one year after surgery. Results At one year the subjective and objective failure rates were 11.6% and 10.5%, respectively. Measures using magnetic resonance imaging were obtained in 73 women. No association was found between continence outcome and post‐operative bladder neck position and elevation. Conclusion The post‐operative position of the bladder neck and the amount of elevation do not influence continence outcome. Post‐operative morbidity (voiding dysfunction and detrusor instability) might be preventable by avoiding excessive bladder neck elevation and compression, without compromising the success of the procedure.