Burch Colposuspension

• Main incontinence surgery for ladies in the previous millennium. Making a resurgence in the post mesh-era.
• Open retropubic vs robotic assisted procedure.
• Lower success rates as the Sling procedure, and more invasive.

Indication:

• Confirmed SUI
• Hypermobile urethra

Procedure:

• Robotic assisted procedure
• Done under a GA
• Sterile filed with BETADINE
• 4 Robotic ports and 2 assistant ports placed
• Abdomen insufflated with CO2
• Head in Trendelenburg
• Prophylactic antibiotics
• An IDC placed
• The retropubic space opened and the para-urethra vaginal wall is lifted and fixed to the pectineal line with 3 sutures on each side
• Tension on these sutures to create a kink in the urethra
• Vagina is inspected to exclude any sutures placed through the wall.
• Abdomen is inspected for any bowel injuries
• Drain is placed

Complications:

• Wound infection
• Ileus
• Acute urine retention
• May require self-catheterization
• Return to theatre to release the tension

Download Information Sheet

Wes Burch Para-Urethral Repair – Open