Burch Procedure for Stress Incontinence

Surgery may be helpful for a problem with bladder control (urinary incontinence). Some signs that you cannot control your bladder are loss of urine with:

  • Straining

  • Coughing

  • Sneezing

  • Laughing

The goal of surgery is to provide more support for the urethra and bladder. Surgery can improve bladder function. About 80% of women are cured with surgery. The Burch procedure is usually done under general or spinal anesthesia. The Burch procedure is described below with greater emphasis on the laparoscopic approach.

THE BURCH PROCEDURE

The Burch procedure is used to restore the bladder and urethra into their normal position. The bladder and urethra can change position through the course of normal aging and childbirth.

PROCEDURE

  • In this procedure, the surgeon lifts the wall of the vagina where the urethra is located.

  • The vaginal wall is stitched (sutured) to tissue near the pubic bone. This corrects the weakness so that the bladder remains stable during activities that might cause leakage such as coughing or sneezing.

  • The Burch procedure can be performed either through open abdominal surgery or by using a laparoscope. A laparoscope is a special telescope-like instrument that your surgeon can look through. This allows the surgeon to operate through small cuts (incisions). With a laparoscopic procedure, 3 or 4 quarter-inch incisions in the belly (abdomen) and groin area are necessary.

  • One of the main advantages of this procedure is a fast recovery time. This is because small incisions require less healing time. Women usually leave the hospital within 24 hours (same day surgery). They often return to normal activities within 7 to 14 days.

RISKS AND COMPLICATIONS

While there are many benefits of laparoscopy, there are relatively few risks. Your caregiver will discuss the risks with you before the procedure. Risks can include:

  • Bleeding

  • Infection

  • Injury to other organs

  • Anesthetic side effects

HOME CARE INSTRUCTIONS

  • Take all medications as directed.

  • You will likely have some mild discomfort in the throat if general anesthesia was used. This is from the breathing tube that was placed in your throat while you were sleeping. You will also have some mild abdominal discomfort and discomfort from the incisions where the instruments were placed into your abdomen. Only take over-the-counter or prescription medicines for pain, discomfort, or fever as directed by your caregiver.

  • Resume daily activities as directed. Showers are preferred. Resume sexual activities as directed by your surgeon.

SEEK IMMEDIATE MEDICAL CARE IF:

  • There is increasing abdominal pain.

  • You develop pain in your shoulders that gets more and more severe. Some pain is common and expected because of the gas inserted into your abdomen during the procedure.

  • You feel light headed or faint.

  • You have chills or fever. If you develop a high temperature, record these and have them ready to show your caregiver when seen.

  • You develop bleeding or drainage from the suture sites or vagina following surgery.

MAKE SURE YOU:

  • Understand these instructions.

  • Will watch your condition.

  • Will get help right away if you are not doing well or get worse.