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Bladder suspension

Bladder suspension refers to surgery that helps place a sagging bladder back into its normal position. Is this type of surgery right for you or a loved one? Here are answers to some of the most common questions, from who may need this procedure to possible complications. 

Why is bladder suspension surgery done?

Bladder suspension (or bladder neck suspension) surgery is a procedure used to treat urine leakage that occurs when a person sneezes, laughs or coughs -- a condition called stress incontinence. Childbirth, as well as hormonal changes such as those brought on by the menopause, can cause a woman to lose muscle tone along the pelvic floor; that can lead to stress incontinence and a need for bladder suspension surgery.

Who needs bladder suspension surgery?

Your GP or urologist may recommend bladder suspension surgery if you have moderate to severe stress incontinence that does not get better with non-invasive treatments such as pelvic floor exercises, medication and electrical stimulation.

For example, bladder suspension surgery may be an option if you develop stress incontinence because of:

  • Childbirth
  • The menopause
  • Problems with the muscles in the bladder and urethra (the tube that carries urine from the body)
  • Surgery

Most often, surgeons perform this type of operation on women. However, the procedure may also be done in men who develop stress incontinence after having all or part of their prostate gland removed.

Before considering bladder suspension surgery it’s important to confirm symptoms are actually brought on by stress incontinence. If need be, seek a second opinion. Bladder suspension surgery only helps treat stress incontinence. It is not helpful for other forms of incontinence. The top reason surgery fails is an incorrect diagnosis.

Types of bladder suspension surgery

There are different ways to place the bladder back to its normal position. Bladder suspension surgical techniques include:

  • Open retropubic suspension surgery
  • Laparoscopic retropubic suspension surgery
  • Needle bladder neck suspension surgery

Open colposuspension surgery involves pulling up the bladder neck and sewing it to the surrounding bone or tissue with sutures. It is a form of abdominal surgery. The surgeon makes an incision in the belly area a few inches below the belly button and locates the bladder and urethra, the tube through which urine flows out of the body. The procedure improves symptoms of stress incontinence that result from sagging of the bladder neck or urethra. Open colposuspension surgery is also called retropubic suspension surgery.

Laparoscopic colposuspension (retropubic) surgery has been around since the early 1990s. It uses a smaller incision than the open procedure to lift the up the bladder. 

Sling surgery uses a piece of body tissue, called fascia, or man-made material to create a sling or hammock-like structure that cradles the sagging bladder neck. This supports the bladder neck and urethra. You can use your own tissue for the procedure (if so, it is removed from your abdominal wall) or donated tissue.

You and your surgeon will discuss which procedure is best for you. Your surgeon will consider the following factors when choosing your procedure: other health conditions you may have, the anatomy of your urinary tract and surrounding structures, and the surgeon's experience.

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