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Urinary Incontinence Surgery—Bladder Suspension

(Retropubic Bladder Suspension; Laparoscopic Retropubic Bladder Suspension; Open Retropubic Bladder Suspension; Transvaginal Suspension)

Definition

Bladder suspension done to ease or correct stress incontinence in women. Stitches are used to support the bladder and urethra.

Female Bladder and Urethra
Bladder and uretha female

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Reasons for Procedure

Stress incontinence is uncontrolled leaking of urine. Weakness in pelvic muscles allow pelvic organs like bladder or vagina to collapse and shift. This can put pressure on organs. It can also put pressure on the tube, called urethra, that lets urine leave the bladder. This makes it hard to control the flow of urine.

Surgery is an option if other treatments haven’t worked. Bladder suspension returns the organs or urethra to their proper place. It should ease urine leakage.

Possible Complications

Problems from the procedure are rare, but all procedures have some risk. Your doctor will review possible problems such as:

  • Bleeding
  • Infection
  • Reactions to anesthesia
  • Inability to pass urine
  • Incontinence continues or comes back
  • Damage to other nearby organs or blood vessels
  • Pain—which can also happen during sex

Talk to your doctor about how to control factors that increase the risk of problems such as:

What to Expect

Prior to Procedure

You may be given antibiotics just before your surgery. Leading up to surgery:

  • Talk to your doctor about your medicines. You may be asked to stop taking some up to one week before the procedure.
  • Arrange for a ride home from the hospital.
  • Don't eat or drink after midnight the night before.

Anesthesia

There are different options for anesthesia. They will depend on what you’re having done, your health history, and what you and your doctor decide is best. These include:

Description of Procedure

The goal is to secure the bladder and urethra back to the proper place. There are different ways to do this. The exact type of surgery will depend on overall health and how much support is needed. The doctor will talk about the risks and benefits of each type for you. Bladder suspension surgery can be done as:

  • Open—A cut is made through the belly wall. The doctor will be able to fully see the bladder and area.
  • Laparoscopic—A few small cuts are made in the belly. Tubes are placed into the cuts. Small tools can be placed through the tubes. The doctor can use a small camera to see the area and complete work. This type of surgery has a faster recovery time than open surgery.
  • Transvaginal—Tools are passed through the vagina. A small cut is made in the wall of the vagina to help create support for bladder.

Stitches can be used to attach bladder and urethra to nearby pelvic bone or ligaments. Sometimes strips of mesh or other tissue may be used as added support. A test is done to make sure everything is in the right place. The doctor will then close cuts with stitches or glue.

Immediately After Procedure

You will be watched in a recovery room. A catheter will be in place. This allows urine to drain while the area heals.

How Long Will It Take?

1 to 1½ hours

How Much Will It Hurt?

Anesthesia will block pain during the surgery. Your doctor will give you medicine to control pain afterwards.

Average Hospital Stay

You may be sent home the same day or next.

Postoperative Care

At the Hospital

A catheter will stay in place until urine is passing as expected. You will be asked to walk around. This helps with healing and lowers the risk of other problems.

At Home

Some activity will be limited until the site is healed. This will include heavy lifting or other strenuous activity for up to 6 weeks.

Call Your Doctor

Call your doctor if you’re not getting better as expected or have problems such as:

  • Signs of infection such as fever or chills
  • Redness, swelling, increasing pain, excessive bleeding, or any discharge from the site
  • Pain that you can't control with the medicines you were given
  • Cough, breathing problems, or chest pain
  • Severe nausea or vomiting
  • Problems passing urine
  • Pain, burning, urgency, or frequency while passing urine

If you think you have an emergency, call for emergency medical services right away.

RESOURCES:

National Institute of Diabetes and Digestive and Kidney Diseases
https://www.niddk.nih.gov

Urology Care Foundation
https://www.urologyhealth.org

CANADIAN RESOURCES:

The Canadian Continence Foundation
http://www.canadiancontinence.ca

Women's Health Matters—Women's College Hospital
https://www.womenshealthmatters.ca

REFERENCES:

Retropubic suspension. Encyclopedia of Surgery website. Available at: https://www.surgeryencyclopedia.com/Pa-St/Retropubic-Suspension.html. Accessed February 5, 2020.

Surgery for stress urinary incontinence. The American College of Obstetricians and Gynecologists website. Available at: https://www.acog.org/Patients/FAQs/Surgery-for-Stress-Urinary-Incontinence. Accessed February 5, 2020.

Surgery for urinary incontinence. EBSCO DynaMed website. Available at: https://www.dynamed.com/topics/dmp~AN~T900644/Surgery-for-urinary-incontinence. Accessed February 5, 2020.

Urinary incontinence. Urology Care Foundation website. Available at: https://www.urologyhealth.org/urologic-conditions/urinary-incontinence. Accessed February 5, 2020.

7/15/2016 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T116102/Hysterectomy: Van Eyk N, van Schalkwyk J, Infectious Disease Committee. Antibiotic prophylaxis in gynaecologic procedures. J Obstet Gynaecol Can. 2012;34(4):382-391.

Last reviewed February 2021 by EBSCO Medical Review Board Adrienne Carmack, MD  Last Updated: 2/5/2020