What do we do when a midurethral tape fails? Rediscovery of open colposuspension as a salvage continence operation.

INTRODUCTION AND HYPOTHESIS: Our aim was to evaluate the outcome of open colposuspension for women with urodynamic stress incontinence who had previously undergone a failed midurethral tape.

METHODS

A retrospective study of 13 women who had undergone open colposuspension after a failed midurethral tape was conducted.

RESULTS

At a median follow-up of 12 months, subjective and objective cure rate were 85% and 77%, respectively. Thirty percent of the women developed de novo detrusor overactivity that responded to antimuscarinic treatment. Long-term voiding difficulty was observed in only one patient, who performed clean intermittent self-catheterization for 3 months. Posterior vaginal wall prolapse requiring pelvic floor repair was found in three women (23%) postoperatively.

CONCLUSIONS

Open colposuspension is an effective option for treating persistent or recurrent stress urinary incontinence after failed midurethral tape, with a high success rate.