What is Urethropexy? Overview, Benefits, and ⁤Expected Results

Urethropexy ‌is a surgical procedure ​used to ‌correct urethral prolapse. It is usually​ performed on the female urinary tract. Urethropexy repairs and strengthens the tissue which‌ is supporting the urethra and helps minimize the risk of‍ future urinary prolapse.



The urethra is a tube that carries urine from the bladder‍ to the outside‌ of the body. It can become weak and stretched as a result of childbirth, pelvic organ prolapse, and other conditions. Urethral prolapse occurs when the urethra protrudes outside the body, causing discomfort or ⁣pain. Urethropexy‍ helps to reinforce and repair the weakened tissue ‌and prevent the urethral prolapse ⁤from‌ reoccurring.

What are the Benefits of Urethropexy?

Urethropexy offers a variety‍ of benefits for women suffering from urethral prolapse.‌ These include:

• Reduced discomfort‌ and ⁢pain: After the procedure, women may⁣ experience relief from the discomfort and pain caused ⁢by the ‌prolapse.



• Improved ​urinary control:‍ Urethropexy can⁣ help improve the strength of ‍the pelvic floor ‍muscles and help reduce urinary incontinence.



• Reduced risk of future prolapse: Urethropexy repairs and strengthens the urethral support‍ tissue, decreasing the chances of a recurrence of⁢ the prolapse.



• Minimally invasive: Urethropexy can usually be performed ⁢on an outpatient basis using laparoscopic techniques ⁢with⁣ minimal⁤ discomfort.

What is Involved in the Urethropexy Procedure?

Urethropexy can typically be completed on ⁣an outpatient basis. The procedure begins with a female patient undergoing general anesthesia. The patient is then placed in the lithotomy position, which allows easier access to‍ the urethra.



Then, using a laparoscopic device, the⁤ surgeon inspects the ‌urethra for any damage and prepares the⁤ tissue for repair. The surgeon may​ then place a bladder needle⁢ or other device to access the⁢ bladder for​ additional repair. Once the repair is complete, the surgeon sutures​ the tissue together to create a stronger⁢ support for ‍the urethra.



The procedure generally takes ‌around 30 minutes to an hour to⁢ complete. After the procedure, patients may experience some swelling and soreness, however, these side effects ⁢typically subside shortly ⁣after the surgery.

What are the Expected⁤ Results of Urethropexy?

Most urethropexy patients⁤ should experience successful relief from their symptoms and a strong urethral support in the long⁣ run. Patients may need to abstain‍ from strenuous activities for a few weeks after the ​procedure in order to give the tissue enough⁤ time to heal.



Urethropexy results can typically be ‌seen within a few weeks of the procedure. Patients should visit ‌their doctor​ for follow-up visits to ensure ⁣the repair has been successful.

Conclusion

Urethropexy is an effective surgical ⁢procedure used to correct urethral prolapse. It is minimally invasive and ⁣can be performed on an ‌outpatient basis.⁤ The procedure strengthens and‌ repairs⁣ the weakened urethral tissues, reducing the risk of a recurrence. Most patients should experience long-term relief from their symptoms and improved​ urinary control.

Definition and Overview

Also referred to as Burch urethropexy or bladder neck suspension surgery, urethropexy is a surgical procedure that involves repositioning the bladder to treat stress incontinence.

The goal of the procedure is to provide more support to the urethra, the tube that drains urine from the bladder and the bladder neck, the point where the bladder and urethra meet, by suturing parts of the tissues of the vagina and attaching them to the pubic bone.

Who Should Undergo and Expected Results

The surgery is performed on patients who have been diagnosed with stress incontinence, or the loss of voluntary control of the bladder due to a weak or poor support of the pelvic floor or muscles.

Stress incontinence, which normally happens among women, can be caused by medications, childbirth, and previous surgery in the pelvis, which can weaken the supporting muscles. In some cases, it can be triggered by certain activities, such as lifting heavy objects and exercising that result in added abdominal pressure.

Urethropexy isn’t often the first course of treatment for stress incontinence. Before it is even considered, doctors recommend non-surgical methods including Kegel exercises that can help strengthen the pelvic floor, biofeedback, and physical therapy. The urologist or gynaecologist may also encourage changes in behavior or lifestyle like smoking cessation, weight loss, and intake of a high-fiber diet that can prevent or reduce the triggers of stress incontinence.

The bladder neck suspension surgery becomes necessary if none of these non-surgical treatments work or if the condition is considered severe.

The procedure has a success rate of more than 80 percent, which means that in the majority of cases, the stress incontinence is completely prevented and does not recur. However, other patients may experience small amounts of leakage especially if the condition is severe.

How Does the Procedure Work?

Bladder neck suspension surgery can be performed using either open traditional technique or minimally invasive method.

Although both surgeries are done on the abdominal walls, they differ in terms of the number of incisions. In open surgery, only one long incision is needed while the surgeon makes three to four small ones in laparoscopic followed by an insertion of a laparoscope that comes with a camera so the surgeon can see the insides clearly. Either way, the bladder neck and the urethra are accessed, sutured with the vaginal tissue, and then all are connected to the pubic bone.

If more support is necessary, the surgeon may create a sling using an autologous or donated fascia or a synthetic graft material.

The surgery lasts for at least an hour while the patient is under general anaesthesia. Before the incisions are closed, a catheter may be inserted through the abdomen to help drain urine during and after the procedure. The catheter is removed within a few days or when the operated area has already healed.

Possible Risks and Complications

Some of the common risks and complications associated with bladder neck suspension surgery are bleeding, an infection that may lead to sepsis, and formation of blood clots, which can be life-threatening if they are dislodged and travel to other parts of the body like the lungs (embolism).

In some cases, the patient may develop a fistula or when the vagina is attached to its skin, and irritable bladder, which creates the urge to urinate more frequently. It’s also possible that the surgery and catheterisation can injure other organs and parts of the bladder and the urethra.

References:

• BURCH JC. Urethrovaginal fixation to Cooper’s ligament for correction of stress incontinence, cystocele, and prolapse. Am J Obstet Gynecol. 1961 Feb. 81:281-90.

• Amaye-Obu FA, Drutz HP. Surgical management of recurrent stress urinary incontinence: A 12-year experience. Am J Obstet Gynecol. 1999 Dec. 181(6):1296-307; discussion 1307-9.

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