Urinary incontinence - retropubic suspension

Alternative Names: Open retropubic colposuspension; Laparoscopic retropubic colposuspension; Needle suspension; Burch colposuspension

Retropubic suspension is surgery to help control urine leakage that can happen when you laugh, cough, sneeze, lift things, or exercise ( stress incontinence). 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:

• Artificial sphincter surgery - urinary
• Urinary incontinence - collagen implants
• Urinary incontinence - tension-free vaginal tape
• Urinary incontinence - vaginal sling procedures

Description of Procedure

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

During open surgery:

• A surgical cut is made on the lower part of your belly.
• Through this cut the bladder is located. The doctor will sew the bladder neck, part of the wall of the vagina, and the urethra to the bones and ligaments in your pelvis.
• This lifts the bladder and urethra so they can close better.

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

Risks of Urinary incontinence - retropubic suspension

Risks for any surgery are:

• Bleeding
• Blood clots in the legs that may travel to the lungs
• Breathing problems
• Infection in the surgical cut, or the cut opens up
• Other infection

Risks for this surgery are:

• Damage to the urethra, bladder, or vagina
• Fistula (connection) between the vagina and the skin
• Irritable bladder, where you may feel the need to urinate more often
• It may be harder to empty your bladder, or you may not be able to empty your bladder and need a catheter (tube that drains urine from your bladder)
• Urine leakage may get worse

Review Date: 1/13/2011
Reviewed By: Louis S. Liou, MD, PhD, Chief of Urology, Cambridge Health Alliance, Visiting Assistant Professor of Surgery, Harvard Medical School. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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