What Burch Colposuspension?
The operation is intended to support the bladder neck, which is the area between the bladder and urethra (pipe that takes urine out).
The aim is to avoid leakage of urine on coughing and sneezing. This is achieved by securing the area around the bladder neck to the back of a ligament (band of fibrous tissue) behind the pubic bone (bone in the lower tummy).
The operation is carried out under general or spinal anaesthesia.
Now tapes are used more commonly as it is less invasive
To whom we offer Burch Colposuspension?
The operation is still offered to selected patients, such as those who are not suitable for tapes and/or those who had problems following previous surgery.
Burch colposuspension is needed for stress incontinence of urine, which refers to leakage of small drops of urine on
coughing and sneezing. Surgery is carried out when conservative measures, such as pelvic floor muscle training, have failed.
What does the operation involve? Principles of surgery
The operation is done through a small bikini-line cut across the tummy. The bladder neck is exposed and 2 or 3 sutures are taken on either side. The abdomen (tummy) is then closed.
General risks as small
Common risks:
Initial difficulty in passing urine. This is usually managed by leaving the catheter (plastic tube) to drain the bladder for longer and you can go home with a leg bag for few days.
Less commonly, patients may need intermittent self catheterisation for a short period of time.
Postoperative pain.
Urinary tract infection, which may need antibiotics.
Wound infection, which may need antibiotics.
Wound bruising and delayed wound healing.
Uncommon risk
Overactive bladder symptoms, such as frequency and urgency of passing urine may happen. These can be managed with medication.
Unmasking of weakness of the back wall of the vagina, leading to its prolapse. This may need pessary or surgery.
Damage to the bladder and/or bowel, which will be repaired at time.
Late onset difficulty passing urine. This may manifest days or even weeks after being able to pass urine smoothly.
The management is the same as initial difficulty passing urine, either by using a catheter with a leg bag and/or clean intermittent self catheterisation.
Post operative recovery
Weeks 4-6 By this time you should resume normal daily activities, but continue to refrain from straining till 3 months after surgery, to ensure good healing of the area around the bladder neck.
Are there any alternatives to having a Burch colposuspension?
Alternative procedures for stress incontinence of urine include:
Mid-urethral tape slings, these are operations that support the urethra using tapes of synthetic material, such as the
tension-free vaginal tape (TVT) sling.
Autologus sling, an operation to support the urethra using a strip from the abdominal (tummy) wall.
Injection of synthetic material at the bladder neck.
What about follow up?
follow up, usually about 12 weeks after surgery. During this follow up appointment, symptoms and quality of life questionnaire will be reviewed and assess wound healing
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