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Urinary Incontinence Surgery
More than 150 operations have been described in medical literature for the treatment of Stress Urinary Incontinence. Unfortunately many of these operations, which are commonly performed throughout the world, have very poor surgical cure rates. A common misnomer of surgical cure is the surgeon is performing a bladder tack operation. Actually the goal for most of these surgeries is to stop urinary leakage and this is accomplished by supporting the urethra. The urethra is the tube that allows urine to be expelled from the body. In an attempt to support the urethra, actually the vagina under and beside the urethra is the area which the operation takes place. The two most successful operations described and researched in the literature are: Pubovaginal Sling procedure and the Burch urethropexy (colposuspension) procedure. These two operations are commonly called the SLING and the BURCH procedures. Though some doctors may argue which is the better of the procedures, there are too many variables for this question to ever be answered scientifically. By narrowing the choice to these two operations the patient is getting one of the most successful operations described in the literature. Interestingly, the most common operation still performed in the United States is the anterior repair and/or Kelly plication.
For surgical treatment information of urinary incontinence surgery, Click here.
Anterior Repair and/or Kelly Plication
Anterior repair (colporrhaphy) has been used to treat stress incontinence in conjunction with a bladder and urethra Dr.op (cystourethrocele) for years. Although anterior repair operation is commonly used for both incontinence and anterior vaginal wall relaxation, anterior repair is probably not the operation of choice for most patients. Anterior repair is a minimally invasive operation that is done through an incision in the anterior vaginal wall but only has a cure rate of 20-30% for stress urinary incontinence. The poor cure rate associated with the anterior repair is quite discouraging and often forces a patient to have a second surgery. Most urogynecologists or urologists would not recommend anterior repair operation, as their procedure of choice, for cure of stress urinary incontinence. Many surgeons who perform both sling and Burch procedures will choose the most appropriate operation based upon the individual patient's needs and urodynamic testing results.
For surgical treatment information of anterior repair, Click here.
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