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Colposuspension

Last updated on 27th March 2016

Colposuspension is an operation which involves the placement of permanent stitches at the level of the bladder neck, which serve to lift up the bladder neck and correct the problem of stress incontinence. Until around ten years ago, colposuspension was the major operation performed for women with stress incontinence, and we have much long term data on its safety and effectiveness. It has now been superceded by the mid-urethral tape procedure (“retropubic” and “trans-obturator”) for the surgical treatment of stress incontinence, although it remains a treatment choice for some women. We are able to perform this operation through keyhole surgery (“laparoscopic colposuspension”), which offers the advantages of less scarring and a quicker recovery, than when the operation is performed through a larger abdominal incision. We would tend to choose this operation for particularly young women, or for women who are already having surgery for significant associated prolapse of particular vaginal muscles.

What happens after the operation?

After the operation, you may experience nausea and wound pain. Medication will be given to relieve these symptoms. You will normally be allowed to drink and eat on the same day of operation.  Some women will have a small drain (a fine tube which stops fluid and blood collecting inside your pelvis by draining it to the outside) which is normally removed the following day. The urinary catheter will be removed usually after three days. Some women will already have gone home and may return to have the catheter removed.  The nurse looking after you will make sure you are passing water without a problem and check there is not a large volume of urine left in the bladder after you have finished urinating.  A small number of women will inadequately empty their bladders. They will go home with a catheter in and come back a week later for removal of the catheter. If a vaginal pack / bandage is used at the time of surgery, it is removed the following day.

You are likely to experience pain in the abdomen / pelvis that will require regular painkillers for a few weeks following surgery.

Are there any risks?

Laparoscopic colposuspension is very safe and effective, but as with any surgical procedure there are risks attached. The risks common to all operations include anaesthetic risks, infection, bleeding, recurrence of symptoms  and formation of a blood clot in the legs/lungs. The main risks specific to laparoscopic colposuspension are:

What should I do after the operation?

You should be back on your feet quite quickly, but you avoid heavy lifting for 6 weeks. There may be some bleeding / brown vaginal discharge as the wounds in the vagina heal which is completely normal.

Sexual intercourse may be resumed after 4 weeks if you are feeling comfortable and the discharge has stopped. We generally suggest at least 4 weeks off work.

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Colposuspension

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