Assessment of long-term patient satisfaction after vesical neck suspension for stress urinary incontinence.

Objective: To determine the long-term efficacy of the transvaginal vesical neck suspension in the treatment of stress urinary incontinence in a general uro-gynecology practice.

Methods: The charts of all patients (n = 168) treated at our hospital with a transvaginal technique for vesical neck suspension, over a 5 year period (1990-1995) were reviewed. Only cases with pure, uncomplicated incontinence secondary to increased intra-abdominal pressure as determined by history and physical examination, urodynamics and cystoscopy were considered. The short term (1 month) and long term (> 5 years) results were collated and analyzed.

Results: Fifty-one patients were lost for follow-up. The assessment of results was, therefore based on the remaining 117 women (69.6%). The efficacy of the operation (> 90% regain continence or were markedly improved) was confirmed in the short term. The results after 5 years were significantly less optimistic with only 26% of the patients remaining fully continent. However, and additional 41% reported better urinary control beyond 5 years after treatment as compared to their situation prior to surgery.

Conclusion: The transvaginal vesical neck suspension is an effective, easily performed surgical treatment for simple stress urinary incontinence. It is free of significant complications. The excellent results in the short term, however, decline significantly with a prolonged period of follow-up.