Abstract
Eighty-seven postmenopausal patients had a colposuspension for urinary stress incontinence. A significant postoperative reduction (p<0.001) of symptoms of frequency, nocturia, urgency and urge incontinence was obtained. The cure rate for urinary incontinence was 77%. Twenty patients were found to be wet postoperatively, 8 due to stress incontinence and 12 due to detrusor instability, 9 of whom had detrusor instability preoperatively.
No differences were found pre- and postoperatively in the cystometric and uroflowmetric values or in the urethral pressure profile measurements. The pressure transmission ratios were significantly improved postoperatively.
During operation and postoperatively, minor complications occurred in this group of patients. In 5 patients blood transfusion was needed. Urinary tract infection was diagnosed in 21 patients, wound infections in 4 patients and enterocele in 5 patients.
Colposuspension for urinary stress incontinence in postmenopausal patients is a safe procedure with a reasonable cure rate indicating that a surgical approach should be adopted in such patients.
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Editorial Comments: This is an extension of the authors' previously published series in SGO [2] now dealing exclusively with postmenopausal patients. Although they state that their overall cure rate was 77%, in fact the cure rate for stress incontinence was 79/87 or 91%. Adding the patients with detrusor instability gives the lower cure rate of 77%. An important contribution of this article is the documentation of a decrease of symptoms of urgency, frequency and urge incontinence subsequent to a modified Burch colposuspension. In addition they document that the pressure-transmission ratios were less than 100% in all of their failed cases. Further studies are needed in the elderly to document success or failure in this group since we will be faced with an ever increasing elderly population in years to come.
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Langer, R., Neuman, M., Panksy, M. et al. Colposuspension for urinary stress incontinence in postmenopausal patients. Int Urogynecol J 2, 208–211 (1991). https://doi.org/10.1007/BF01923386
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DOI: https://doi.org/10.1007/BF01923386