Stress urinary incontinence is a term that describes any accidental or involuntary loss of urine from the bladder and is a surgical procedure in which the neck of the bladder is suspended from nearby ligaments with sutures.
The Burch procedure is used when the bladder or urethra has fallen out of its normal position leading to stress urinary incontinence.
The space between the bladder and anterior abdominal wall is entered and structures are identified.
Paraurethral space dissected up to the urethrovesical junction and mid urethra. Sutures are taken from the periurethral tissues and anchored to the cooper’s ligament. The laparoscopic suspension is a safe and effective procedure as it eliminates mesh-related complications like mesh erosion and infection.
VAULT PROLAPSE – POST HYSTERECTOMY
Vault prolapse is a condition in which the upper portion of the vagina (apex) sags and enters into or outside of the vagina in a patient who has undergone a hysterectomy. It is because of the weakness of the pelvic and perineal muscles. Causes of weakness are childbirth injuries, obesity, chronic cough, chronic constipation, age-related weakness. It could be associated with prolapse of the bladder (cystocele), rectum (rectocele) or small bowel (enterocoele)
Vault prolapse can be treated by a laparoscopic procedure called sacrocolpopexy in which the surgeon attaches the surgical mesh from the vagina to the ligament in the sacrum, thereby pulling the vault up and anchoring it to a fixed strong point. The minimally invasive procedure allows for decreased blood loss, decreased postoperative pain and faster recovery.