Vesicosuspension for female stress incontinence and cystocele using pubic bone anchors

Objective. The purpose of this study was to evaluate the results of vesicosuspension for female stress incontinence and cystocele using fixation with pubic bone anchors in a cohort of patients operated on by a single surgeon. Methods. Using a standard questionnaire, an independent female interviewer not employed by the surgeon's practice contacted 100 consecutive patients with stress incontinence and/or cystocele who had undergone vesicosuspension using suprapubic fixation with bone anchors between October 1996 and July 1997. The patients' responses were recorded on a computerised database and analysed. All procedures were performed by a single surgeon (A.J.V.). The duration of the operation was normally 45 minutes, the patient was mobilised on day 3 postoperatively, and the catheter removed on day 7. Results. The mean age of the 100 women was 50.4 years (range 26 - 84 years) and the mean follow-up was 11 months (range 1.4 - 19 months). Previous operations for incontinence had been performed in 44 patients. Preoperatively 56 patients had to wear protective pads, using an average of 4.4 pads per day, and 36 had to change underwear because of urine leakage. Postoperatively 14 patients had to wear protective pads, using an average of 3.5 pads per day, while 11 had to change their underwear because of urine leakage. Only 3 patients used a catheter to empty the bladder, 2 used medication for incontinence, and none had had a subsequent operation for urine leakage. Postoperatively 16 patients reported having problems with pain in the pelvis, and 6 had pain during intercourse, but there were no cases of osteitis pubis. Subjective improvement reported by the patients was 93% on average, and overall patient satisfaction with the procedure was 8.6 on a scale of 0 - 10. In total, 89 patients said they would be prepared to undergo the operation again, while 92 would recommend it to a friend. Conclusion. The use of pubic bone anchors for colpo-suspension is safe and reliable, with results comparable to those of other methods, and the added advantages of faster mobilisation and few short-term complications.