EARLY VOIDING DIFFICULTY AFTER COLPOSUSPENSION

Objective To determine the incidence of post-operative voiding dysfunc tion (POVD) after colposuspension and to identify pre-operative risk f actors. Patients and methods A retrospective study of 100 women having colposuspension to determine the preoperative clinical assessment (hi story, physical examination, symptom-specific questionnaire and visual analogue scare assessment of urological symptoms), pre-operative urod ynamic investigations (uroflowmetry, twin-channel subtracted cystometr y and video-cystourethrography), information on post-operative cathete r management and the presence and management of any POVD. Results Twen ty-one women experienced significant POVD attributable to their colpos uspension. This resolved within 6 months in 19, but persisted beyond 6 months in two. Women experiencing POVD were significantly older and w ere more likely to have previously undergone a hysterectomy. The risk of POVD was 12% for those aged <50 years, 25% at age 50-64, and 50% fo r those over 65 years. The duration of post-operative catheterization was related to the presence of symptoms of voiding difficulty. Conclus ions The risk of POVD after colposuspension increases with age. In wom en over 65 years old, consideration should be given to an elective tem porary discharge home with a suprapubic catheter in situ for 7-10 days before initiating a catheter-clamping regimen.