Surgical Treatments

Surgical treatments for stress incontinence


Burch retropubic urethropexy

Procedure done through an abdominal incision or through a laparoscope to re-support the bladder base by placing sutures in the vagina to attach it to a ligament on the pubic bone.
 

Suburethral sling

Placing a "strap" of material under the urethra to support it and prevent stress incontinence. The sling material can be synthetic or natural. The natural material can be taken from your own body or from cadavers.
 

Tension-free vaginal tape – type-sling

A special type of suburethral sling that requires a less invasive procedure, which allows it to be performed under local anesthesia on an outpatient basis.
 

Suprapubic catheter

A catheter placed into the bladder through the abdomen - it is used to drain the bladder after surgery.
 

Neuromodulation

This is a new approach in the treatment of the overactive bladder, urinary retention and urinary frequency. Electrodes are surgically inserted into the nerves that control the bladder.

Surgical procedures to correct prolapse


Anterior colporrhaphy

A vaginal procedure to reestablish the supports between the bladder and vagina to fix a cystocele. A synthetic mesh or organic graft material may be placed to reinforce this repair.
 

Paravaginal repair (vaginal or abdominal approach)

Support the vaginal wall by attaching it to the pelvic sidewall to fix a cystocele. A synthetic mesh or organic graft material may be placed to reinforce this repair.
 

Posterior colporrhaphy

A vaginal procedure to reestablish the supports between the vagina and rectum to fix a rectocele. A synthetic mesh or organic graft material may be placed to reinforce this repair.
 

Transvaginal enterocele repair

Close the space between the vagina and rectum through a vaginal incision to prevent the small bowel from pushing the vagina out. This procedure will also re-suspend the top of the vagina.
 

Total abdominal hysterectomy (with or without bilateral salpingo/oophorectomy)

Remove the uterus (including the cervix), tubes and ovaries through an
abdominal incision.
 

Total laparoscopic hysterectomy

Removal of the uterus (including the cervix) and possibly the tubes and ovaries through a laparoscopic approach.
 

Total vaginal hysterectomy (with or without bilateral salpingo/oophorectomy)

Remove the uterus (including the cervix), tubes and ovaries through a
vaginal incision.
 

Bilateral salpingo/oophorectomy

Removal of tubes and ovaries (performed either abdominally, vaginally
or laparoscopically).
 

Uterosacral ligament suspension

Suspend the top of the vagina to the uteroscral ligaments. This can be performed vaginally, abdominally or laparoscopically.
 

Sacrospinous vaginal vault suspension

A vaginal procedure that attaches the top of the prolapsed vagina to a ligament in the pelvis.
 

Sacral colpopexy

A procedure (performed abdominally or laparoscopically) that attaches the top of the prolapsed vagina to the sacrum using either synthetic mesh or cadaveric material.

 

Illiococcygeal fascial attachment

A vaginal procedure that attaches the top of the prolapsed vagina to pararectal supportive tissue.
 

Supracervical hysterectomy

Removal of most of the uterus – leaving the cervix behind. This approach can be done abdominally or laparoscopically.

Total colpectomy

Complete closure of the vagina to correct prolapse. This procedure is only performed when the patient is ABSOLUTELY sure that she will never want to have
intercourse again.

Total colpocleisis

Closure of the vagina (similar to colpectomy) while leaving channels at the side for drainage from the uterus (which is not removed).

Overlapping anal sphincteroplasty

Reattach divided muscle edges around anus to correct fecal incontinence.