Stress incontinence is leakage of urine when you cough, laugh or exercise. The cause of stress incontinence is breakage of the ligaments that support the neck of the bladder (pubo-urethral ligaments). The cause of this breakage is usually a combination or childbirth, wear and tear through heavy lifting and the effects of aging. When stress incontinence is mild and the ligaments have only partially broken, pelvic floor exercises may be useful in reducing stress incontinence. If the ligaments have broken completely an operation is usually required to repair the ligaments. A number of different operations are now available to treat stress incontinence. However not all cases of incontinence are due to stress. Special tests called urodynamic studies may be necessary prior to surgery to prove that the problem actually is stress incontinence. In general terms, an operation is required if you leak urine every day and constantly need to wear a pad, or have frequent accidents
Laparoscopic Burch colposuspension
At Endoscopy Manawatu we treat stress incontinence surgically with the Laparoscopic Burch Colposuspension operation. This is based on the open Burch colposuspension operation which has been around since 1962 and is considered to be the gold standard for the treatment of stress incontinence. A Laparoscopic Burch Colposuspension is the same operation except it is performed through keyhole surgery. The results are the same with approximately 90% of women completely dry after the operation. You will only need to be in hospital 24-48 hours after a laparoscopic Burch procedure.
A colposuspension operation entails inserting two nylon sutures on each side of the bladder neck and attaching them to the pubic bone. These sutures act as a scaffolding for new ligaments to grow around.
The most common complication that occurs after surgery is difficulty passing urine. This is usually only temporary. A special catheter called a supra-pubic catheter may be needed to drain the bladder for a few days or even a few weeks after the operation. It is important not to do any heavy lifting for about three months following the operation while the new ligaments form.
Laparoscopic suture placement