Colposuspension - bladder neck suspension surgery
Colposuspension is a procedure that may be recommended for some women to treat stress incontinence and involves bringing a sagging bladder neck back to its normal position.
The bladder neck is given better support by a surgeon lifting up vaginal tissue surrounding the neck of the bladder using sutures ( stitches) to anchor it to the back of the pubic bone.
Who needs colposuspension?
Stress incontinence is the most common form of incontinence where urine can leak under extra pressure on the bladder.
One of the causes of stress incontinence is weakened support for the bladder, sometimes after childbirth or operations.
Surgery may be an option after a stress incontinence diagnosis if other non-surgical approaches have not been successful.
The risks and benefits of the procedure will be discussed before going ahead with it.
Colposuspension may be carried out as keyhole (laparoscopic) surgery or open surgery. Recovery times are generally shorter with keyhole procedures.
With keyhole surgery the operation is done with instruments through small incisions.
With open colposuspension the operation is done through a large incision.
The operation is usually done on the day you are admitted to hospital. Instructions will have been given not to eat or drink for a certain time beforehand.
After preparations are completed you'll be taken to the operating theatre and the operation will be done under general anaesthetic or spinal anaesthetic.
Once you come round from the operation, you'll be asked about pain or discomfort and pain relief will be given.
A catheter to drain urine from the body and a drainage tube from the wound will usually be in place for a couple of days.
There will be a chance to ask any questions about the procedure and express any concerns.
The stay in hospital is usually around 5 days.
Details will be given about how to continue the recovery once you get home and when you can resume usual activities, including having sex and driving.
The operation usually needs at least 2 weeks off work, avoiding heavy lifting and no sex for a month.
Instructions will also be given about what to do if you have concerns, such as pain or infections.
Some blood in the urine or vaginal discharge may be seen for a month after the operation.
A follow-up appointment will also be made and the surgical team will let your GP know about the procedure having taken place.
All operations have risks. With colposuspension, the British Association of Urological Surgeons says there is a 1 in 10 chance of:
- The operation not helping the incontinence, or incontinence returning later
- Bladder infections
- Bladder not emptying fully, urine retention
- Urinating more often
- Increased urge to pee
- Painful sex
- Prolpase or bulging of rectum into the vagina (rectocele)
More rarely, there can be infections from the operation, bleeding, perforated bladder or damage to ureter tubes.