What is surgical bladder suspension?
Bladder suspension surgery, also known as bladder neck suspension, is a procedure that is used to treat stress incontinence in women. There are a variety of types of bladder suspension surgeries that use stitches to support the bladder and urethra.
The goal of the procedure is to lift the bladder and urethra by lifting it and securing it to nearby structures such as the pelvic bone. The bladder is less likely to leak after the procedure.
Who is a candidate for a surgical bladder suspension?
Bladder suspension is most appropriate for patients who suffer from moderate to severe stress incontinence that does not get better with conservative treatments. Stress incontinence is a type of urinary incontinence that occurs when a woman sneezes, laughs or coughs.
Patients may develop stress incontinence because of:
- Surgery in the pelvic area
- Problems with the muscles in the bladder and urethra
Risks of a surgical bladder suspension
Complications after a bladder suspension surgery are rare, but may occur. Complications may include:
- Urinary tract infection
- Difficulty or inability to urinate
- Recurrence of stress incontinence
- Pain during sexual intercourse
- Damage to blood vessels or organs near the bladder
- Vaginal prolapse
- Reaction to anesthesia
- Overactive bladder
What to expect during a surgical bladder suspension
A bladder suspension procedure is typically performed in a hospital setting under general or spinal anesthesia. Depending upon how much bladder support is needed, your doctor will determine the type of procedure that will be used.
Surgical options include:
- Open retropubic suspension surgery
During an open procedure, your doctor will make a large incision in the abdomen to access the bladder. Once the area is open, your doctor will locate the bladder and urethra, pull the bladder neck up and sew it into the nearby bone or tissue.
- Laparoscopic retropubic suspension
During a laparoscopic procedure, your doctor will make two to three smaller incisions into the abdomen and above the pubic bone. Small surgical instruments will be used to perform the procedure. Although laparoscopic retropubic suspension allows for a quicker recovery and shorter hospital stay, results show higher complication rate.
- Transvaginal procedure
During a transvaginal bladder suspension, a small incision is made in the front of the vaginal wall to access the bladder and urethra. Once accessed, your surgeon will lift the bladder neck and sew it into the surrounding bone or tissue.
- Sling surgery
During a sling surgery procedure, your doctor will create a hammock-like structure that will cradle the bulging bladder. The “sling” will support the bladder and urethra to help relieve the symptoms of stress incontinence. In many cases, your doctor can use your own tissue from your abdominal wall or use donor tissue.
The entire procedure takes approximately 90 minutes.
Your doctor will evaluate your case to determine which option is most appropriate for you.
Recovery from surgical bladder suspension
Patients who have a mesh sling inserted can go home that day, but if you have a retropubic suspension surgery or sling surgery, you may need an overnight hospital stay.
Results from surgical bladder suspension
Bladder suspension surgery has a high success rate, but symptoms can recur over time. If symptoms return, you may need a second surgical bladder suspension.