Clinical outcome or abdominal urethropexy-colposuspension: A long-term follow-up

The aim of this study was to investigate the long-term results of abdominal urethropexy-colposus-pension ill terms of cure rate of stress urinary inco ntinence, complications and side effects. Between 1985 and 1992, 169 women between 27 and 79 years old underwent abdominal urethropexy-colposuspension at Stockholm Slider Hospital. In 1997 they were invited to participate in a long-term follow-up study, 5-11 years after the operation. One hundred an d thirty-one women (78%) were willing to attend for a clinical review; 38 w ere lost to follow-up. At the follow-up visit all women were assessed with medical history, symptoms of incontinence, and their satisfaction and probl ems after the operation, following a predefined protocol. Peri- and postope rative data were retrieved from the files. The patients underwent a gynecol ogical examination, measurement of residual urine volume and a provocative leakage test. One hundred and nine women (83%) were satisfied with the resu lts of the operation and 22 (17%) were not. Seventy-one (54%) were subjecti vely completely dry, 48 (35%) had a little leakage and 14(11%) had frequent leakage; 122 women were continent in the provocation test, and only 9 (7%) demonstrated leakage. The cure rate for stress incontinence was 93%. Accor ding to their medical histories 63 (48%) women had mixed incontinence befor e their operation. At the follow-up examination 43 of these 63 women still had symptoms of urgency. Twenty-six women with genuine stress incontinence before the operation had developed urgency or urge incontinence during the follow-up period. Urge symptoms before operation was a negative prognostic factor for a good outcome in terms of subjective cure of incontinence, but had no impact on objective cure rate or satisfaction of the operation. The cure rate for stress incontinence was high but still there were women who w ere not satisfied with the operation. Most of these complained of urge inco ntinence. There were few serious complications. The objective cure rate was better than the subjective cure rate.