Surgery Overview
Retropubic suspension surgery is used to
treat
urinary incontinence by lifting the sagging bladder
neck and
urethra that have dropped abnormally low in the pelvic
area. Retropubic suspension is abdominal surgery, where access to the bladder
and urethra is gained by making an incision in the abdominal wall. This surgery can be done by making one big incision (open surgery) or several small incisions (laparoscopic surgery).
The most common procedure used for retropubic suspension is:
- Burch colposuspension, in
which the vaginal wall is attached to a ligament (Cooper's ligament) next to
the pubic bone.
What To Expect After Surgery
Since these procedures involve
abdominal surgery, hospitalization is required. To allow healing of the urinary
tract, a
catheter is placed into the bladder through the
urethra (or abdominal wall) to allow urine to drain. The catheter is usually
removed in about 10 days.
You will likely go home 2 to 3 days
after the surgery if there have been no complications. The time it takes for you to recover depends on if you had open or laparoscopic surgery.
If you had laparoscopic surgery, you will probably be able to go back to work and most of your usual activities in 1 to 2 weeks. If you had open surgery, it may take a little longer, about 2 to 4 weeks. For either surgery, you may need 4 to 6 weeks to fully recover. Try to avoid heavy lifting and strenuous activities. These might put extra pressure on your bladder.
The
amount of pain you experience after surgery depends on the exact nature of your
procedure, your physical condition at the time of surgery, and your own
response to pain. You will probably feel some pain at the incision site and may
feel some cramping in your abdomen. Your doctor will prescribe medicine to
relieve your discomfort during the first few days after surgery. Be sure to
call your doctor if you cannot get relief from pain.
Women who have laparoscopic surgery usually have shorter recovery times. They may also have less pain after surgery, have a shorter hospital stay, and return to normal activities faster than women who have open surgery.1
Many women
have some constipation after this surgery. You can try some things to avoid constipation:
- Include fruits, vegetables, beans, and whole grains in your diet each day. These foods are high in fiber.
- Drink plenty of fluids, enough so that your urine is light yellow or clear like water.
- Take a fiber supplement, such as Citrucel or Metamucil, every day if needed. Start with a small dose and very slowly increase the dose over a month or more.
- Schedule time each day for a bowel movement. Having a daily routine may help. Take your time and do not strain when having a bowel movement.
Tell your doctor if you still have constipation after you have tried these methods.
Why It Is Done
Retropubic suspension is used to
correct
stress incontinence that is caused by sagging of the
urethra and/or bladder neck.
How Well It Works
Retropubic suspension is considered
to be effective in relieving stress incontinence. Most women have fewer
symptoms of stress incontinence after this surgery.
For stress incontinence, doctors have been doing Burch colposuspension surgeries longer than sling surgeries. Many studies have been done on the Burch colposuspension surgery. About 9 out of 10 women are cured ("dry") during the year after surgery. After 5 years, about 7 out of 10 women are still "dry."2
Risks
Complications of retropubic surgery may
include:
- Difficulty urinating after surgery.
- New symptoms of urgency or urge incontinence.
- Internal bleeding.
- Infection at the
incision site.
- Injury to an organ (such as the bladder, urethra, or
ureters).
- Pelvic organ prolapse (usually, enterocele).
All surgeries that use
general anesthesia have a small risk of death or
complications. All surgeries carry some risk of infection.
What To Think About
Retropubic suspension procedures
require that a thin, flexible tube (catheter) be
kept in place for a day or more, until you can get up independently to use the
toilet. The catheter may be uncomfortable. And it increases the risk of getting a
urinary tract infection.
Before having
surgery for urinary incontinence, ask your doctor about the following:
- How much success has the doctor had in treating incontinence with surgery? The success of surgical
procedures for urinary incontinence depends on the experience and skill of the
surgeon.
- Is there anything you can do to increase the likelihood of a successful surgery? Losing weight, quitting smoking,
or doing pelvic floor (Kegel) exercises prior to surgery may increase the
likelihood of regaining continence after surgery.
Complete the surgery information form (PDF)(What is a PDF document?) to help you prepare for this surgery.
References
Citations
- Ellis DN, et al. (2006). Laparoscopic colposuspension for urinary incontinence in women. Cochrane Database of Systematic Reviews (3).
- Lapitan MCM, et al. (2009). Open retropubic colposuspension for urinary incontinence in women. Cochrane Database of Systematic Reviews (4).
Credits
| By | Healthwise Staff |
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| Primary Medical Reviewer | E. Gregory Thompson, MD - Internal Medicine |
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| Specialist Medical Reviewer | Avery L. Seifert, MD - Urology |
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| Last Revised | September 13, 2010 |
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Ellis DN, et al. (2006). Laparoscopic colposuspension for urinary incontinence in women. Cochrane Database of Systematic Reviews (3).
Lapitan MCM, et al. (2009). Open retropubic colposuspension for urinary incontinence in women. Cochrane Database of Systematic Reviews (4).
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