Long-term 5-year followup of the results of the vesica procedure

J Urol. 2005 Apr;173(4):1234-6. doi: 10.1097/01.ju.0000149030.31634.42.


Purpose: We evaluated the long-term results of Vesica (Boston Scientific Corp., Watertown, Massachusetts) percutaneous bladder neck suspension for stress urinary incontinence.

Materials and methods: A total of 40 women with urodynamically proven stress urinary incontinence (SUI) underwent Vesica percutaneous bladder neck suspension between 1994 and 1997. Patients were assessed at 6 months, 12 months and 5 years with a simple questionnaire to elicit whether they had experienced any adverse effects, whether they were dry and whether further investigation or a surgical incontinence procedure was offered.

Results: Only 1 of the 40 women was lost to long-term followup. Initial results were excellent with 85% of women reporting complete dryness at 6 months. However, wound infections developed in 16% of patients secondary to hematomas in the suprapubic incisions and 10% required a period of intermittent self-catheterization. By 12 months only 46% of women remained dry, although most only reported occasional leakage. At 5 years 69% of patients had recurrent SUI and more than two-thirds of this group (70%) had symptoms severe enough to be offered a further surgical procedure. Patients undergoing subsequent secondary procedures were found to have fraying of the suspensory sutures at the bone anchor.

Conclusions: Initial results of this minimally invasive procedure were excellent and despite the lack of long-term data the technique rapidly came into widespread use. The 5-year outcome shows a 31% continence rate. We no longer advocate this particular form of bladder neck suspension for SUI.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Bone Nails
  • Female
  • Follow-Up Studies
  • Hematoma / etiology
  • Humans
  • Longitudinal Studies
  • Middle Aged
  • Minimally Invasive Surgical Procedures / adverse effects
  • Minimally Invasive Surgical Procedures / methods
  • Postoperative Hemorrhage / etiology
  • Recurrence
  • Surgical Wound Infection / etiology
  • Suture Techniques / adverse effects
  • Treatment Outcome
  • Urinary Bladder / surgery
  • Urinary Incontinence, Stress / surgery*
  • Urination / physiology
  • Urologic Surgical Procedures / adverse effects
  • Urologic Surgical Procedures / methods