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Urinary incontinence - retropubic suspension

Contents of this page:

Alternative Names   

Open retropubic colposuspension; Laparoscopic retropubic colposuspension; Needle suspension; Burch colposuspension

Definition    Return to top

Retropubic suspension is surgery to help control stress incontinence, urine leakage that can happen when you laugh, cough, sneeze, lift things, or exercise. The surgery helps close your urethra (the tube that carries urine from the bladder to the outside) and the bladder neck (the part of the bladder that connects to the urethra).

See also:

Description    Return to top

You will have either general anesthesia or spinal anesthesia before the retropubic suspension procedure. With general anesthesia, you will be asleep and feel no pain. With spinal anesthesia, you will be awake but numb from the waist down. You will not feel pain.

There are 2 ways to do retropubic suspension, open surgery or laparoscopic surgery. Either way, surgery may take up to 2 hours.

During open surgery:

During laparoscopic surgery, the doctor will make a smaller incision in your belly. A laparoscope (a tube-shaped medical device that allows the doctor to see your organs) is put into your belly through this cut. The doctor will sew the bladder neck, part of the wall of the vagina, and urethra to the bones and ligaments in the pelvis.

Why the Procedure is Performed    Return to top

This procedure is done to treat stress incontinence.

Most of the time, your doctor will try bladder retraining or Kegel exercises before talking about surgery with you.

Risks    Return to top

Risks for any surgery are:

Risks for this surgery are:

Before the Procedure    Return to top

Always tell your doctor or nurse what drugs you are taking, even drugs, supplements, or herbs you bought without a prescription.

During the days before the surgery:

On the day of your surgery:

You may be asked to shave your pubic area before the operation.

After the Procedure    Return to top

Most people will have a catheter in their urethra or above their pubic bone after this surgery so that urine can drain from the bladder. Some people may need to go home with a catheter still in place, or they may need to perform intermittent catheterization. This is a procedure where you use a catheter only when you need to urinate. You will be taught how to do this before you leave the hospital.

Many patients leave the hospital 2 or 3 days after this surgery.

You may have gauze packing in the vagina after surgery to help stop bleeding. It is usually removed 24 to 36 hours after surgery.

Outlook (Prognosis)    Return to top

Urinary leakage decreases for most women who have this surgery. But you may still have some leakage. This may be because other problems are causing your urinary incontinence. Over time, some or all of the leakage may come back.

References    Return to top

Chapple CR. Retropubic suspension surgery for incontinence in women. In: Wein AJ, ed. Campbell-Walsh Urology. 9th ed. Philadelphia, PA: Saunders; 2007:chap 65.

Takacs EB, Kobashi KC. Minimally invasive treatment of stress urinary incontinence and vaginal prolapse. Urol Clin North Am. 2007;35(3):467-476.

Update Date: 1/13/2009

Updated by: Louis S. Liou, MD, PhD, Assistant Professor of Urology, Department of Surgery, Boston University School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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