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Surgeries for female stress incontinence

Alternative names

Urethral suspension; Marshall-Marchetti operation; Vesicourethral suspension; MMK; Pubo-vaginal sling; Birch procedure; Trans-vaginal tape procedure


This is a surgery to control involuntary urination by elevating the urethra and bladder.


Open bladder and urethral surgeries are usually performed to prevent urine leakage associated with stress incontinence (involuntary leakage of urine when laughing, coughing , sneezing , or lifting, which can result from deformity or damage to the urethra and bladder from decreased muscle tone caused by multiple births, menopause , or other causes).

This problem is usually associated with a cystocele. A cystocele is when the bladder sags into or even outside the vagina. The patient can often feel this during sexual intercourse or may even see the bladder protruding outside of the vagina.

Surgery attempts to return the bladder and urethra to its normal position in the pelvis. This surgery can be performed in many different ways, depending of the patient's anatomy and the severity of the problem.

The two most common ways of performing this surgery is through the abdominal wall or though the vagina. Some of the procedures require general anesthesia and others require only local or regional (spinal) anesthesia.

You will usually return from surgery with a Foley catheter and/or a suprapubic catheter in place. The urine may initially appear bloody, but this should gradually resolve.

The Foley or suprapubic catheter may be removed several days after surgery when you are able to completely empty your bladder. Occasionally, the catheter will need to remain in place for as long as 3 months, depending on the person's ability to empty the bladder completely.


Repair of the bladder and urethra may be recommended for treatment of stress incontinence (inability to prevent urine leakage when coughing, sneezing, laughing, jumping, walking, sitting, or standing).


Risks for any anesthesia are:
  • reactions to medications
  • problems breathing
Risks for any surgery are:
  • bleeding
  • infection

Expectations after surgery

This surgery can be very helpful for patients with stress incontinence .


The amount of time it takes to recover from surgery depends on the individual. Based on an evaluation of your health status prior to surgery, your health care provider can give you a good estimate of the recovery time.

Update Date: 5/25/2002

Young Kang, M.D., Department of Urology, Columbia University College of Physicians and Surgeons, New York, NY. Review provided by VeriMed Healthcare Network.

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Last updated: Tue, 06 Jan 2009 00:20:03 GMT