Cochrane Summaries

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Needle suspension surgery for urinary incontinence in women

Glazener CMA, Cooper K
Published Online: 
20 January 2010

Stress urinary incontinence is loss of urine when coughing, laughing, sneezing or exercising. Damage to muscles that hold up the bladder may cause it. About a third of adult women may have urine leakage, and about a third of these may have problems bad enough to require surgery.

When non-surgical methods, such as exercising the muscles in the pelvic floor (the base of the abdomen) or drugs have not worked, surgery is sometimes used to lift and support the neck of the bladder to help stop urine leaking. Needle suspension involves tying sutures between the vagina and the abdominal wall.

The review found ten trials which studied 375 women having six different types of needle suspension operations and compared them with 489 women who received other treatments. Most of the trials were small or of poor quality, making their results less reliable. More women were cured after abdominal operations such as colposuspension (84%) than after needle suspension (71%), both women who had and had not had a previous operation for incontinence. There was not enough evidence about complications, or how needle suspension compares with other operations. Needle suspension operations were not compared with conservative treatments such as pelvic floor exercises or drugs.

In summary, needle suspension surgery appears to be less effective for urinary incontinence than abdominal surgery, and there is not enough evidence comparing it to other treatments.

This record should be cited as: 
Glazener CMA, Cooper K. Bladder neck needle suspension for urinary incontinence in women. Cochrane Database of Systematic Reviews 2004, Issue 2. Art. No.: CD003636. DOI: 10.1002/14651858.CD003636.pub2
Assessed as up to date: 
7 September 2009