Colposuspension in girls with refractory stress-incontinence, a critical evaluation of a last-resort treatment
Year: 2024
Type: article
Abstract: Introduction: We previously presented promising results with a Burch-type colposuspension (BC) in a heterogeneous group of girls with therapy-resistant daytime incontinence (DUI). In view of our clinical observations, we expect that a small group of girls with refractory DUI based on stress-urinary incontinence (SUI) might also benefit from a BC in order to achieve continence. Objective: To assess the (long-term) effect of BC on refractory DUI in girls with SUI, and to identify predictive factors for success. Study design: =34) was performed. Patients were considered refractory after having failed all non-invasive treatment methods. The main outcome measurement was continence, expressed as the percentage of children with decreased incontinence at post-surgical follow-up without any additional treatment (complete response 4-6 months after surgery). Additionally, a cross-sectional follow-up was carried out, assessing the long-term effect of BC on DUI and patient satisfaction by means of standardized questionnaires. Results: Complete continence after surgery was achieved in 12% (4/34) and 12% (4/34) showed a decrease in frequency of incontinence episodes. Patients with an abnormal flow pattern more often failed complete continence or improved incontinence. After a mean duration of 8 years, 84% (16/19) still experienced DUI. 68% (13/19) of those patients would opt for the BC again. Conclusion: Although 84% of children still experienced any degree DUI after a mean duration of 8 years after BC, most patients do not regret the decision of surgical treatment. Given the limited benefit and invasiveness of the procedure, however, we discourage to routinely perform BC in children with refractory DUI and SUI. Our results should be taken into account when discussing expectations and chances of success.
Source: Frontiers in Urology
Language: English
Subfield: Rheumatology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,125
OpenAlex ID: W4404866339