Colposuspension


If you have tried simple treatments for incontinence, like pelvic exercises without any improvement after some time you may want to consult your doctor for a laproscopic colposuspension.

This type of procedure is the most common type of operation for stress incontinence.

The word is made up of two words: Colpo-: Prefix referring to the vagina-Suspension : to hang from.

The operation involves placing permanent stitches at the neck of the bladder to return the bladder to its original position. Sometimes the bladder will slip or move down from where it should be and this operation corrects this.

Once the surgery is completed the operation it has a high degree of success for most patients and can prevent any further leaking of urine if successful.

It is performed successfully by lifting up the vagina and securing its position by using stitches to tie it permanently to an area behind the pubic bone

Some years ago colposuspension was considered major surgery with a large incision to be made in the pelvic region.Recovery took longer and there is always the risk of internally scarring, infections and further complications.


 

Today some surgeons still perform this procedure with a major cut in the abdomen which is called:

1.Open retropubic colposuspension

There are two main types of this procedure:

 "Burch procedure": This is the most common type. The stitches are tied to the cartilage behind the pubic bone .

The other less risky related procedure is called:

2. Keyhole  surgery (or laproscopic colposuspension)

It's done with a special tube called a laproscope which is a long tube with a light, a camera, and instruments at the end inserted through a small keyhole cut in the belly where an image or camera allows the surgeon to operate on the subject area.

This has several benefits in that it is first of all is less life threatening from a surgical point of view because the keyhole procedure is less invasive making it much safer , there is generally less internal scarring of organs and recovery is generally much faster .It is the most common form of surgery today for the treatment of stress incontinence.

With any surgery,however, there are always risks involved and the main risks with laproscopic colposuspension can be: bleeding, infection, damage to the bladder, pain and some nausea following the operation.

Some other risks may be damage to organs like the bladder, bowel, pelvic muscles, and kidneys and if there is slight damage a catheter may need to be worn longer to aid in the recovery of the bladder. 

Many women have a catheter inserted for 2-3 days and this is to see if you are passing urine OK and to give everything time to settle down after surgery.

Some women may retain urine for a longer period so the catheter may be used for a longer time. There is is a  small percentage of women who retain urine following surgery (about 3%) but  this can generally correct itself.

There are also some women who have urgency to empty the bladder which may last for a period of months before generally correcting itself. Following the procedure there are regular checkups with a doctor to see all is improving. Generally about 2-3 months will pass before everything is back to normal.

Laproscopic colosuspension has been regarded as safe and effective and its benefits long lasting.

Incontinence surgery for older women over 70 can carry a higher degree of complications than younger women which may result in extended antibiotics and intermittent self-catheterisation and possible urinary tract infections. 


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