Stress incontinence

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Anterior vaginal wall repair	Female urinary tract	Male urinary tract	Stress incontinence
Stress incontinence

ANTERIOR VAGINAL REPAIR OR PARAVAGINAL REPAIR

These vaginal procedures are often done in women when the bladder is bulging into the vagina. (Such a condition is called a cystocele). An anterior vaginal repair is done through a cut in the vagina, and a paravaginal repair may be done through a cut in the vagina or abdomen.

In an anterior repair, the supportive tissue between the vagina and bladder is folded and stitched together so the bladder and urethra are in proper position.

In a paravaginal repair, the supportive tissue between the vagina and bladder is stitched to the tissue covering the pelvic floor muscles, so the bladder and urethra are supported.

Studies have shown that the cure rate for stress urinary incontinence from these procedures is about 40-65%. Often, these procedures are done along with another procedure for stress incontinence such as a retropubic suspension.

NEEDLE BLADDER NECK SUSPENSION

Needle bladder neck procedures use special needles to make a minor cut in the abdomen and vagina. The various procedures (Modified Pereyra and Stamey procedure) differ based on the structures that are used to anchor and support the bladder. This type of surgery is only done on women. Women treated with needle bladder neck procedures have a 40-80% cure rate. Because the success rate tends to be lower than other surgeries, they are not being done as often as they used to be. Possible complications include urinary tract infection, inability to urinate, wound infection, fistula (rarely), and urge incontinence.

RETROPUBIC SUSPENSION

Retropubic suspension is used to describe a group of surgical procedures done to lift the bladder and urethra. These procedures are done through a cut in the abdomen. The procedures (Burch colposuspension and Marshall-Marchetti-Krantz -- MMK) differ based on the structures that are used to anchor and support the bladder.

Women treated with these procedures have a 75-90% cure rate. Possible complications include urinary tract infection, inability to urinate, wound infection, fistula (rarely), and new onset of urge incontinence.