We would like to thank our colleague for clarification on the efficacy of repeat colposuspension after a primary, secondary or tertiary procedure. A recently published Cochrane review of Burch colposuspension found insufficient data to comment on redo surgery. However, the study published by Robinson et al., quoted by our colleague, states success rates of 65–86% for repeat colposuspension. We would agree that similar results are obtained with mid urethral slings for redo surgery. A recent review of the management of recurrent stress incontinence specifically after a failed mid urethral sling suggests a cure rate of up to 70% for a secondary sling. Furthermore, an evaluation of risk factors for failed surgery suggests that multiple vaginal deliveries is the main risk factor for repeat surgery, but that synthetic slings at index surgery may be associated with lower risk of failure.
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