Colposuspension

This is considered the gold standard for bladder repair, but in the last couple of years has been superseded by insertion of a tension free vaginal tape (TVT, see below).

The operation can be performed under general (asleep) or regional (awake) anaesthetic and takes about 1 hour. The abdomen is opened so that the bladder and the vagina can be visualised. The bladder and vagina dissected free so that sutures (stitches) can be placed in the vagina, beside the bladder. These stitches are then tied to the bone behind the bladder so that the neck of the bladder is elevated, making it more able to control leakage of urine.

Complications

As with all surgery, there are risks, and the benefits of having the operation must always be balanced against the potential harm from the operation. The vast majority of women who have surgery will have very few problems and the operation will result in a great improvement in the quality of the patient’s life. However there are potential complications that you should know about.

The common complications of a colposuspension are infection (bladder infection, wound infection), bleeding (blood transfusion may be required), and bladder damage. If the bladder damage is repaired at the time of surgery, there should be no long term problems.

Antibiotics are given at the time of the surgery to reduce the risk of infection. Anticoaguulants (thin the blood) are usually given to reduce the chance of a clot forming in the leg (we also use special stockings and get you mobilised out of bed early to reduce the risk).

Fortunately the number of serious complications associated with colposuspension are uncommon, but can include life threatening haemorrhage, bowel damage and a clot on the lung. Where a patient has fasted (nothing to eat or drink for 6 – 8 hours before surgery), the risk of an accident with the anaesthetic are very low. The risk of dying from a ‘colposuspension’ is approximately 10,000:1.